Proceedings of the North Carolina Dental Society

NORTH CAROLINA HISTORY OF HEALTH DIGITAL COLLECTION  

Volumes 44 (1918)

DOCUMENT NO. NCHH-33-044   

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OF THE

NORTH CAROUNA DENTAL SOCIETY

FORTY-FOURTH ANNUAL MEETING

HELD AX

WRIGHTSVILLE BEACH, N. C.

JUNE 19-21, 1918

Reported and Transcribed by DR. WHITFIELD COBB WINSTON-SALEM, N. C.

Winston Printing Company

winston-salem, n. c. 1918 OFFICERS AND COMMITTEES 1918-1919

Officers.

J. N. Johnson, President Goldsboro, N. C. R. T. Gallagher, First Vice President Washington, N. C.

A. S. Cromartie, Second Vice-President Fayetteville, N. C. W. T. Martin, Secretary, Benson, N. C. R. M. Morrow, Treasurer Burlington, N. C. D. E. McConnell, Essayist Gastonia, N. C. Committees

EXECUTIVE R. M. Squires, Chairman, Wake Forest, N. C. Raleigh, N. C. P. R. Falls, Gastonia, N. C. J. Martin Fleming, ethics Wilson, N. C. J. R. Edmundson, Chairman, E. R. Warren, Goldsboro, N. C. I. H. Davis, Oxford, N. C. legislative

F. L. Hunt, Chairman, Asheville, N. C. Raleigh, N. C. E. Tucker, Roxboro, N. C. J. Martin Fleming, J. auditing Whitfield Cobb, Chairman, Winston-Salem, N. C. Forest, N. C. Sam Levy, Charlotte, N. C. J. A. Yarborough, Wake oral hygiene Winston-Salem, N. C. J. C. Watkins, Chairman, T. P. BuLLARD, Roseboro, N. C. Oscar Hooks, Wilson, N. C. exhibits Joseph Fulton, Chairman, Asheville, N. C. Asheville, C. R. A. Little, Asheville, N. C. J. W. Faucette, N. program H. L. Keith, Chairman, Hendersonville, N. C. W. F. Bell, Asheville, N. C. J. S. Spurgeon, Hillsboro, N. C. board of examiners Raleigh, N. C. J. Martin Fleming, Chairman, F. L. Hunt, Secretary, Asheville, N. C. S. Spurgeon, Hillsboro, N. C. J. S. Betts, Greensboro, N. C. J. N. C. C. A. Thompson, Wilson, N. C. J. H. Wheeler, Greensboro, DELEGATES TO NATIONAL ASSOCIATION F. L. Hunt, Asheville, N. C. R. M. Morrow, Burlington, N. C. ALTERNATES C, C. L, Alexander, Charlotte, N. C. J. C. Watkins, Winston-Salem, N. :

PROCEEDINGS

Auditorium,

Wrightsville Beach, N. C, June 19, 1918.

The forty-fourth annual meeting of the North Carolina Dental Society was called to order Wednesday evening, June 19, 1918, at 9:20 o'clock, by the President, Dr. R. M. Squires, of Wake Forest, N. C. The invocation was made by Dr. John Jeter Hurt, Pastor of the First Bapitst Church, Wilmington, after which the President introduced Hon. P. Q. Moore, Mayor of Wilming- ton, who in welcoming the society to Wrightsville Beach and to Wilmington, said Mr. President, Ladies and Gentlemen:

It is a great pleasure that I have tonight to greet you and to welcome you in behalf of the people of Wilmington and to tell you how glad we are to have you with us and to wish you God speed in the work in which you are engaged; and it is my pleasure and privilege tonight to tell you about the spirit of the people of Wilmington, how they are working day and night to help win this war in which we are engaged and to tell you of the splendid spirit that they are showing individually and collectively in this regard. When the Governor of North Carolina called upon me to name a

Board of Registrars here, if I had known the immense amount of work that would fall upon the shoulders of these men, if I had known the fear- ful responsibility that would be placed upon them, I would have hesi- tated; but I had the honor and the pleasure of naming J. Allen Taylor and Chas.C. Chadbourn; and I want to tell you that these two men have devoted practically their whole time, day and night, not taking the one dollar which many rich men of the country have been taking, but they have refused the dollar. They have practically given up all of their private business and they have gone further. These men have given their boys. J. Allen Taylor's only boy today is over in France. The two splendid boys whom Chas. C. Chadbourn has educated, trained, loved and watched grow up around him as his own have been sent as aviators and they are flying for America. We are building ships here now, and this is what you are interested in, because of the fact that what we do here in Wilmington in the way of shipbuilding for the purpose of winning this war, is for North Carolina, and the nation. You are vitally interested because Wilmington is your seaport city and what North Carolina does in the way of shipbuilding is of vital interest to all American citizens. 4 Proceedings North Carolina Dental Society

I saw General Julian S. Carr, an old Confederate soldier, raise the United States flag over the Steel Ship Yard: and as the flag reached the peak and was flying in the breeze, I saw tears glistening in his eyes and

heard him say, "This is beautiful, the most beautiful scene I have ever witnessed." A few days ago we had the pleasure of witnessing the raising of another flag—the flag that flies on the first Government owned concrete ship plant in America. We are building ships here and we will build more ships. We are going to build ships that will carry across the waters food and ammunition. We will build ships that will carry across the waters our soldier boys and when we get sufficient ammunition and enough food and the desired number of our boys across the water, we are going to take Old

Glory and place it upon the ramparts of Berlin itself and keep it there, until every German knee shall bow in salutation to the Stars and Stripes. You have heard tonight that Arthur Bluethenthal has been killed, the first Wilmington boy to make the supreme sacrifice across the water. He has given his life for liberty, for civilization and for God. Our people have heard the call of brave American men, women and little children as they were hurled down beneath the waters of the ocean by the sneaking, lurking submarines and we have heard the cry of the Red Cross nurse, Edith Cavell, who so tenderly nursed the German wounded and dying and while ministering to her own beloved English soldiers, how she was made to face a German firing squad. We have heard the call of poor unoffending Belgium, of bright, sunny France; and we have heard the call of dear old mother England. We are answering their calls, answering by sending across the waters the young men of Wilmington and the young men of North Carolina, who are going forth determined to pull the teeth of the kaiser, and I know of no men better qualified to remove the teeth of the monster than the members of this organization. American manhood supported by the brave womanhood of the land will pull his teeth so that he cannot make war upon old men and women, upon defenceless towns, upon hospitals, upon the wounded and dying, upon ships with the Red Cross flag floating above them and upon nurses of the Red Cross and wounded American boys. We will pull his teeth so that the world may be made safe for liberty and justice and civilization.

I am glad my friends, to welcome you here and in the name of thirty thousand people I bid you welcome and I hope that this meeting will prove one of the greatest of your organization. I trust that your stay here will be one round of pleasure and profit.

Dr. S. R. Horton, of Raleigh, N. C, in responding to the address of welcome, said: Mr. President, Officers and Members of the North Carolina Dental Association, Ladies and Gentlemen:

I am indeed proud to be the mouthpiece of the dentists of North Caro- lina, than which there are no better patriots or champions for the com- Proceedings North Carolina Dental Society 5

mon weal. I am positively sure that I voice the sentiment of every person present when I say we respond in every fibre of our being to the gracious and happy welcome we have just received. Replying to the very patriotic welcome we have just received I would not be true to our boys across the water did I not speak some word of appreciation for our boys and warning for ourselves.

I have never loved the negro as now for they are doing their duty cheerfully and have refused to be contaminated by the Hun plotters. Every one of us have a duty to perform in this war, whether we shoulder a gun in the defense of our country or remain at home. It is not enough that we buy bonds and stamps but we must be ever on the alert for German lies and nail every one of them that reaches us so that it may go no further, and if necessary, nail the man that presents it. Just as the great ocean purrs and pats the shore into a lethargic slum- ber and then comes with its storm tossed waves and tears it asunder and sweeps it away to the mighty deep and everlasting oblivion so would the treacherous, damnable Hun lull us to sleep with his lying treacherous tongue, with his treacherous profiteering and his damnable sneaking plots and intrigue, snatch that glorious flag that means so much to us and hurl it under the blood-soaked heels of the hell-born and hell-bent kaiser who would tear us from this lovely land and all we hold dear to bear us away on the waves of cruel German Kultur till we sink at last into a loathsome oblivion. Mr. Mayor, we are tired children come home to the great playground of North Carolina to work and play and rest. If in our forgetfulness of dignity and propriety we make some mistakes, forgive and forget and do not, we beg you, let the warm spot in your heart, we hold, grow cold, for some of us will come again to these happy shores for play and recrea- tion. We want you to come and play with us in old Neptune's bath and when these gay and frolicsome hours are over come into our clinics and lecture rooms for we can be serious when the occasion arises. Being serious reminds me of a darky deserter who was captured not far from Charlotte and when arrested by the officer and questioned he answered flippantly the questions as to what camp he was from, etc., and the officer said: "Look here, Tom, do you know that your offense is one of the gravest of the catalogue of crimes against the government," and catching the negro by the shoulder he said in his commanding voice, "Now Tom, be serious," to which Tom replied: " I'se serious Captain. You see, it's dis way wid me, my mammie is dead and in Heaven and my pa he's dead and in hell and I done got a sister in Charlotte and I'm gwine to see one of dem before night."

Ladies and Gentlemen, I am thoroughly convinced that no profession can rise above the public conscience. Learn all you can about your mouth for it is the golden gate through which the life-giving elements pass into your body to produce health and happiness or the loathsome cavern, full of creeping things, that pollutes you as you eat, drink, breathe or sleep, and condemns you to misery and an early death. Demand of 6 Proceedings North Carolina Dental Society

us higher standards, force the laggards to meet the needs of the hour. Again let me, in the name of the finest dentists and gentlemen in the finest State and of the greatest country in the world, thank you for the kind offer of your hospitality and to assure you we are glad indeed to exchange, for a brief period at least, the peevish hum of a dental engine for the deep and melodious roar of the grand old Atlantic.

The Secretary then called the roll.

On motion, the reading of the minutes of the last meeting was dispensed with.

With the Second Vice-President, Dr. L. G. Coble, of Greensboro, in the chair, the President read his address: PRESIDENT'S ADDRESS. Dr. E. M. Squires, Wake Forest, N. C. Members and Friends of the North Carolina Dental Society: Another year has passed. It has been a year like no other in the history of the world—full of struggle and suffering, of fiendish hate and

compassionate mercy. Through all the months of it our profession has continued to prove itself worthy the marvelous heritage of a glorious past. At the close of such a year of achievement in the dental world and on the threshold of even greater things, I greet you gladly this evening as the North Carolina Dental Society for the forty-fourth time as- asembles to exchange experiences of the past and lay larger plans for future service. I trust that you will join me in thanks to the other officers and the committees for whatever success this meeting can claim as it takes its place in the State history of our profession. Words are but empty sympols: therefore would I seek by genuine service to this society to express my personal appreciation of the kindness its members have shown me. It is impossible to estimate the value we receive from our dental meetings, both as dentists and as men. To touch elbows in a common cause necessarily means growth of personality as well as profession.

Hence I plead for your earnest consideration in the organization of city, county and district societies; not alone for mutual help in solving dental problems, but also for the fellowship we so much need in our profession. If we could have more social contact with each other, many of our petty jealousies would disappear. "But never clasping hand in hand, Both often fail to understand That each intends to do what's right And treat each other honor bright.

"Then let no doubting thought abide, But firm good faith on either side. Confidence to each other give. Living ourselves, let others live." Proceedings North Carolina Dental Society 7

We should give more time to our operations—be thorough; our services will then be worth more, the people given better care, and instead of taking his we shall have patients to send to the other fellow. Let us rival each other in the quality rather than in the number of operations. Remuneration will be as much, or more, and humanity will be better served.

It is through the efforts of local and state societies in cooperation with the National that we today have equal status with the medical profession in the army, and hope soon to have in the navy. We must continue and increase our loyalty to all of these organizations. The National deserves the sincere gratitude of the profession for what it has done along the lines of publication, research and legislation. And what it has already accomplished is but the beginning of what it is destined to do in future years.

On account of some irregularities in voting in previous years, I beg to remind you that according to our Constitution and By-Laws no member who is in arrears for dues is eligible to office or has a right to vote in this Society. At our annual meeting in 1912 there was a motion passed that the Treasurer read the names of those entitled to vote just previous to an election. I would suggest that this be done when there is more than one candidate for office. Our Constitution and By-Laws and Code of Ethics have not been revised in seventeen years. Some of the articles have become obsolete and many sections changed. I would therefore suggest that a committee of three be appointed at this meeting to revise our Constitution and By-Laws and Code of Ethics and submit to our next annual meeting for approval. This should be done with a view to having them published, together with our new Dental Law, in booklet form, a copy placed in the hands of every member of this Society and also a copy presented to each new member received into our organization. Here at Wrightsville, in the old Atlantic's most delightful breezes, we met three years ago. We come back with the membership of our Society increased 50%—a clear gain of 100 in this brief time. There has been no stirring campaign to "compel them to come in." To what cause then may we honestly attribute this most gratifying result? I beg leave to suggest that our lengthened roll is due largely to the action of a re-organizing committee that, just three years ago, instituted a Progressive Clinic and Lecture Course. By furnishing our clinicians some tangible remuneration and the opportunity to present their subjects in an orderly way to interested groups of their profession, we have stimulated them to give us their best, America's best. And it is hardly necessary to say again that America's best in dentistry is the world's best. It is true worth that counts and attracts. The preacher or the Sunday School teacher who must needs be everlastingly trying some new scheme to induce people to hear him, should seek another job. Say something worth while and you will have a grateful audience. "Deliver the goods" and there will always be someone to receive them. Serve 8 Proceedings North Carolina Dental Society good programs and the numbers, sooner or later, will crowd to enjoy them. Our unsurpassed State Dental Law, national legislation—which has been accomplished by local, state and national organizations—and the wonderful research work of our country, proclaim themselves our strong allies in drawing fellow-practitioners into cooperative activity. With their aid we should go from strength to strength, making our annual meetings so potent in influence, so magnetic in worth, that we shall at- tract to active participation every true son of the profession from the mountains to the sea. Let us take as our slogan, THE BEST, applying

it not only in our everyday practice but also in this Society, making our programs so strong in information and inspiration, in teaching and training, that the appeal shall be irresistable. For years we were content to feed our annual papers and discussions from our meager experiences supplemented by material from the dental journals. Then we advanced a step, calling in expert clinicians to tell us how to do new things and do the old in better ways; showing to the limited few who could crowd around, best methods of best work. Has not the time come for us again to forward march? We in North Carolina must not lose step with those in the front ranks. Every modern educator knows that effective teaching is neither telling nor showing, but telling, showing and doing combined. We have had Amalgam Technique given in this Society; yet how many of us still mix amalgam in the hand, put it in the cavity with the fingers, and push it down with a round ball burnisher? Never using a matrix band, never carving our fillings, never polishing them at a later sitting. Dr. Johnson, an expert in Amalgam Technique, will show us a better way. Do not argue that we cannot get pay for this grade of work. We must begin by doing things for which we are not fully paid if we ever wish to be given value for what we do. We have had the Closed-bite Impression and Anatomical Articulation. How many of us really give our patients the benefit of this instruction, even though there are numbers of them who want this kind of service and gladly pay the price when we show them the difference? Are we doing root-canal work that will stand the scrutinizing search-light of the X-ray? We have had Con- ductive Anaesthesia; yet how many of us except those who have taken the course under Dr. Hancock or some other specialist, really practice Pro- it? The same is true of Pyorrhea Treatment, Cavity Preparation, in phylaxis, etc. Dr. Simpson, great teacher of dentistry and master crown and bridge work, lectures to us tomorrow. He cannot help us few much in the limited time he has except to inspire us and give us a work practical points But if you and I could, for a week, do the actual under his direction, we should go home with our ideas of crown and bridge work revolutionized, with a sufficient mastery of the subject to give our patients an entirely different class of work from that which they have been receiving at our hands. We are not doing the things which we have seen and heard. We forget what we have been told and shown because we do not practice them. We do not practice them because we lack confidence in ourselves, knowing that we do not possess the technique Proceedings North Carolina Dental Society 9

acquired by actually doing the work under the direction of a master- teacher.

For all these reasons, gentlemen, I most earnestly recommend: That we advance the further step which Oklahoma has already taken and other states are considering; that we establish a thorough Post-Graduate Course of one week on two or three subjects; and that the Executive Committee work out the details for such a course. In this way our clinician will not only tell us and show us, but he will see that we ourselves do the actual work until we are proficient in the line he teaches. Thus knowing and DOING we shall master the details of each step so completely that we shall no longer hesitate to practice what we have learned. With, confidence in ourselves, we can go back to our oflRces, not alone to testify that we have seen, but to do that we have done. In this way we shall give to our patients that which they deserve and that for which they are willing to pay, when once they understand that we are giving them only the best.

In teaching and in preserving the dental organs we are responsible to our fellow-men for a great service, as Dr. Stevenson will show us. At present our 50,000 dentists to 100,000,000 people—a ratio of one to 2000—is wholly inadequate. Scientific research has proved what a large factor the dentist is in the health of the world. Others besides Charles Mayo are being convinced that "People will not die of plagues as in time past, but will die of simple infections originating above the collar." Our State Boards of Health with their literature and work in the public schools, the oral hygiene propaganda, medical cooperation, recent work of the Dental Surgeon's Corps of Army and Navy, and the activities of the Preparedness League of American Dentists—all of these agencies are leading the majority of our population to an ever increasing demand for dental services. Our state and municipal governments, as well as charitable institutions, are realizing that dentistry is not merely a luxury for the rich, but a necessity for everyone within their jurisdiction. This is the day for economy. What will the tax-payer say when he fully comprehends that one-third of the retarded pupils in our schools are due to bad oral conditions, and that it requires decidedly more of his money to keep a retarded child in school an extra term than it would take to keep its mouth in good condition? He will swell the cries for help from our profession which are already more than we can answer. The reconstruction period after this war must find us ready to meet its needs. It behooves us to plan along newer and larger lines, and plan NOW. When we consider the untold troubles arising from abscessed teeth and pyorrhea pockets, and the difficulty of curing these maladies, we are convinced that our work in future must necessarily be in the field of prevention. To summarize: many conditions are gradually increasing the demand for dental practitioners beyond the already inadequate supply—a supply decreased at present for military reasons. In view of this established fact, I beg to commend to your careful thought the new branch of our profession, the Dental Hygienist Course. While 10 Proceedings North Carolina Dental Society helping us to discharge our responsibility to humanity, this Hygienist Course will incidentally furnish employment to some of the women who because of this war must earn their own livelihood. Dr. Fones, of Bridge- port, Conn., has forseen this new day, and in his city meeting it with master plans, training women assistants who shall go out as lay-apostles to further the work. Do we really mean that school children should be taught prophylaxis, or are we merely talking? Can dentists afford to do this work while patients are actually suffering for attention? Does not the solution of this great problem of teaching lie in the training and licensing of dental nurses? These women, working under the supervision of registered dentists, can make examinations and records of teeth, give class room talks, tooth brush drills, stereoptican lectures, prophylactic treatments, and instruct in the home care of the mouth. Perhaps the day is not far distant when the dental hygienist, like the school teacher, shall be employed by the government. Indeed do you not begin to forsee the time when the nation, plainly realizing the care it owes its people, shall take full charge of all health propaganda, select dentists and physicians by civil service examination, and commission them to keep its millions of subjects physically fit for life and duty. These dental nurses would also help us to solve the problem of discharging our professional obligation to our eleemosynary institutions—to the deaf-mute, the blind, the prisoner, the poor. Dr. Fones also suggests that they be sent to give our soldiers and sailors the instruction in dental hygiene which they so much need.

Nor does institutional work limit the field of usefulness for these women assistants of our profession. Have you ever toiled faithfully on a piece of work, making it as nearly perfect as your skill and conscience could, but to have it come back in all too short a while in such condition that you were ashamed to own it? And all because no care was given to the mouth after the work was done. To those of us who take pride in a job well accomplished, this is one of the most discouraging phases of the profession. Speed the day when every reputable dentist in this state and nation shall have in his office a dental hygienist to keep clean and healthy every mouth which he has endeavored to put in good condition; and—till such instruction is given in our schools—to have a class of the children and adults within his practice, both teaching and helping them to keep mouths clean and healthy, thus preventing the great ravages of decay, loss of teeth, pulpless and abscessed teeth, pyorrhea, and the absorption of pus from these focal points. When we have shown the public what can be accomplished in this way, it will not be necessary to plead for appropriations to establish these clinics in our public institutions.

Therefore, members of this Society, I beg to submit the twofold recommendation: That we give our hearty support and cooperation to those institutions preparing young ladies for this work; and, that we appoint a committee to secure the enactment during the next Legis- lature of laws to regulate the practice of dental hygienists in this state, Proceedings North Carolina Dental Society 11 providing for a dental commission—either within or apart from our Examining Board—which shall examine applicants for this work. My heart is in these suggestions, and I hope soon to see this branch of our profession firmly established in our midst.

In this world struggle between autocracy and democracy, I am proud to be an American. When I reflect on the work of the Preparedness League of American Dentists, which, begun less than two years ago, has grown to a membership of more than 13,000 out of a profession num- bering only about 46,000 in the United States, I am proud to be a dentist. I am glad that Dr. Hunt, director for this state, will later tell us about the scope and plans of this work both in our own state and throughout the nation. In the words of Major Heckard: "The plan of drive for making dentally fit our new National Army has been a case of I-will-go- where-there-is-no-path-and-I-will-Ieave-a-trail! A way was made. It was a zigzag road at times, beset with many surprises; but it is now a road from which the rocks and ruts are fast disappearing." This is the highway of freedom, justice, mercy, service. Let us induce others to walk it with us, continuing to serve those who are called in the cause of humanity "Till it's over, over there." As dentists let us do not merely our bit, but our utmost, cooperating with the League in all of its plans and purposes. The hour has struck when we must everyone acquit ourselves like dentists and like men, for when the bloody Hun crossed the Belgian border "the bells of destiny rang round the world." Let me quote from a great address recently delivered by a college president: "The issues of this struggle are more fundamental and universal than any over which the iron dice of war ever before rattled. If they are decided adversely, the spiritual heritage of the race is forfeit and civilization disappears once again down the maw of barbarism. I cannot fancy a book of doom big enough to record the guilt of the men who precipitated this atrocious war. But America's participation for the defence of her national ideals and the ordered life of the world, is as righteous as it is splendid. With President Wilson we are all glad to fight for mankind. The final issue cannot be doubtful. Meantime it throws a blood-red gauntlet at our feet, challenging our nation, our religion, our culture and ourselves.

. . . And whether you dice with death while mad guns curse overhead, or in more homely ways give yourselves to the highest you see and the best you know, live or die, not for flag or clan or class

But for a dream born in an Artisan's shed And for the secret Scripture of the poor." In this fateful hour, may we as members of a great profession and citizens of a favored land be worthy the sublime sentiments expressed by President Wilson when he recently said: "I have always been proud to be an American, and was never more proud than now, when all that we have said and all that we have fore- seen about our people is coming true. The great days have come . . . when they see at last the high uses for which their wealth has been piled 12 Proceedings North Carolina Dental Society up and their mighty power accumulated, and counting neither blood nor treasure, now that their final day of opportunity has come, rejoice to spend and be spent through a long night of suffering and terror, in order that they and men everywhere may see the dawn of a day of righ- teousness and justice and peace."

Drs. J. C. Watkins, J. S. Spurgeon and Rosebud Morse were appointed by the Second Vice-President to report on the President's address.

The President, Dr. Squires : The next order of business is the Annual Essay. I would like to say that Dr. Tucker wrote me recently that he would be unable to come, and I suppose he was so pressed for time that he did not write the essay and we will have to dispense with that. The Secretary read the names of the following applicants for membership, as reported by the Executive Committee, the applicants being elected members at a later session:

J. B. Montgomery, Wilmington.

J. T. Underwood, Wilmington. Italy M. Morse, East Bend. Joseph V. Turner, Hester.

E. E. Harrison, Jr., Olin. G. A. Lazenby, Statesville. W. C. Weatherman, Statesville. Henry V. Murray, Rock Creek. Oscar Ernest Culler, Rock Creek.

J. D. Gregg, Liberty. W. M. Newton, Spartanburg, S. C. E. W. Hunter, Goldsboro. B. C. Thomasson, Bryson City. R. S. Turlington, Clinton. R. H. Ellington, Salisbury.

J. H. Nicholson, Harmony. W. F. Jones, North Wilkesboro. Wm. G. Nimocks, Fayetteville. L. Justice Dupree, Angier. D. P. High, Wilmington. Chas. C. Poindexter, East Bend. W. Clyde Current, Statesville. Floyd G. Johnson, Hamptonville.

J. J. Hamlin, High Point. Proceedings North Carolina Dental Society 13

Ella B. Cox, Palmerville. D. LeRoy Pridgen, Dunn.

J. Frank West, Weldon. S. B. Bivens, Marshville. C. H. Lennon, Rowland. R. F. Graham, Rowland. E. W. Tatum, Mt. Olive. R. W. Crews, Thomasville. Z. V. Parker, New Bern. R. F. Walters, Virgilina, Va. After the reading of announcements, the president declared the meeting adjourned until Thursday morning.

MORNING SESSION, JUNE 20.

The second session of the North Carolina Dental Society was called to order Thursday morning, at 9:55 o'clock. Those whose applications for membership were read at the Wednesday evening session, having been reported favorably by the Executive Committee, were elected to membership. The names of the following applicants for membership were reported favorably, the applicants being elected to membership after an adjournment of a few minutes:

R. D. Tuttle, Stokesdale. Wm. Mercer Wall, Weldon. H. L. Kell, Farmville. Chas. H. Bryan, Apex.

C. J. Thornhill, Apex. Wm. C. Mercer, Fountain. L. M. Massey, Wakefield. W. T. Moore, Farmville.

Dr. J. Martin Fleming: It might not be amiss just at this point to say that Dr. Everitt could not be here this morning. However, he has had a recent letter from Dr. R. G. Sherrill, whose health has given away again, and he has sold out and burned all bridges behind him and says he never expects to touch another dental instrument. He has sent a message of remembrance to the boys, and I would like to suggest that his name be changed from the active to 14 Proceedings North Carolina Dental Society the honorary roll and a message of good will be sent to him to Tryon, N, C. This suggestion was put in the form of a motion and motion carried. The message sent was as follows: Greetings and best wishes from the North Carolina State Dental Society. W. T. Martin, Sec.

Dr. R. L. Simpson, of Richmond, Va., was then introduced, and spoke in part as follows: Mr. President and Members:

It is a distinct honor to be invited to address theNorth CaroHnas

Dental Society, and I feel particularly honored that you have given this morning to me, and have Dr. Martin Fleming's command to "go a far as you like." There are two serious ambitions of my life, first to do dental work as well as it can be done, second to show the other dentists when I have learned to do a thing. The first ambition keeps me working all the time and keeps alive the enthusiasm of life. The second ambition is sometimes boring to my friends. Let us hope it will not prove so in your case today. My subject is Some Principles of Fixed and Removable Bridge Work. If you had asked me for such a paper two years ago I should have declined to read it because the frenzied advocates of the latter had disturbed me until I was uncertain about the best method to use after giving the subject all that was in me and observing as widely and carefully as possible, I have come to some positive conclusions as to what is best for you and for me and for our patients. 1. The radiograph must be used to determine which teeth should be extracted and the jaw must be studied as a whole so as to determine what type of work is to be done, whether fixed or removable.

2 There is most emphatically a place for both fixed and removable bridge work in dentistry.

3 No pulp should be devitalized if it can be avoided, and it can be avoided in the vast majority of cases.

4 There is no need for mutilation of teeth,

5 There is no need for a glaring display of gold.

The best part of my address is the fact that I am presenting nothing original. I have made a selection of the best, and it is my desire to make you more enthusiastic about old friends and introduce to you some new uses for them. Incidentally it is a source of pride to know that in coldly selecting the best we should be grateful to so many Southern men.

For inspiration and help I am indebted to Drs. C. L. Alexander,

T. P. Hinman, J. K. Burgess and F. R. Getz, for abutments and clasps, and to Dr. W. B. Cummer, of Toronto, Canada, for general principles of removable work. Proceedings North Carolina Dental Society 15

Here followed a description, demonstration and large charts of clasps.

CLASPS

Materials:—24 g. S. S. W. and Weinstein clasp metal.

GETZ CLASPS

Materials:—Half-round 14 g. clasp wire and larger, and Weinstein casting gold E. HINMAN HOOD ABUTMENT

Materials:—24 k. 36 g. gold plate; 23 and 22 g. round wire of Iridium Platinum, Neyoro or noxidium; 22 k. solder; No. Yi and No. 1 round burrs. ALEXANDER HOOD ABUTMENT

Materials:—24k. 36g. gold plate; 22k. solder.

BURGESS PINLAYS

Materials:—23 and 22g. round wire of Iridium Platinum, Neyoro or noxidium; 22k. "Dark Gold" and trace of Clasp Metal or Weinstein's hard gold for inlays; No. Yi and 1 round burrs. GILMORE ATTACHMENT

Materials:— 14g. round wire of Iridium Platinum or Neyoro; Gilmore's own clasp or one made of 24 g. Clasp gold plate with soldered lug of Platinoid. OPEN TUBE AND SPLIT PIN ATTACHMENT

Materials:—24g. Clasp Metal plate; 12g. split pin of Clasp Metal.

SPLIT PIN AND TUBE ATTACHMENT (For Roots)

12, 14, 16g. Split Pin of Clasp Metal. Tubes of same metal to fit. YIRIKIAN ATTACHMENTS

These are sold already made. LINGUAL AND PALATAL BARS

12g. round Clasp Metal, rolled to 9g. or S. S. W. oval clasp metal wire in two sizes.

WIRE TO JOIN CLASP TO BASE

14g. round wire slightly plattened, of Clasp Metal or Neyoro. INDIRECT RETAINER

14g. round Clasp Metal wire or Neyoro wire.

The above principles were then applied to individual cases by means of large charts. In the absence of Dr. H. O. Lineberger, the following paper was read by the Secretary:

L 16 Proceedings North Carolina Dental Society

ORAL AND PLASTIC SURGERY

Capt. H. O. Lineberger, D. R. C.—Base Hospital No. 65

The term Oral Surgery has become very familiar in the Dental profession, but the term Oral and Plastic Surgery opens up a field much larger than that usually considered under the former class. In this paper I shall endeavor to cover very briefly the course given at Officers School of Oral and Plastic Surgery in the City of Philadelphia. In the first year of the War, little or no attention was paid to the restoration of a man's face, and apparently they were contented to merely remove the loose sequestrums of bone and slough tissue allowing the part to heal as best it would. In a case of a fractured mandible such an operation would end in what is usually termed a "bird-faced man." It was these, with other sad failures in Oral Surgery which caused the Surgeon General to call in the dental surgeons to help out. The dentists have responded cheerfully, and have rendered magnificent and encourag- ing assistance. When a man receives a wound in the trenches he is first dressed in a dugout by the First Aid Dressing Station. Here the hemorrhage is arrested, foreign bodies removed; and in case of a bone fracture, relieved as best can be done in a limited time. Next, in the Evacuation Hospital, the wound is opened up and thoroughly dressed, but rarely ever are the severely wounded patients operated on until they reach the Base Hos- pital.

The treatment in a Base Hospital is as near like civilian Surgery as can be made in a War zone. The wound is thoroughly washed out with normal salt—Di-Chloromene-T-Ether, bichlorides or some other antiseptic. In case of a fractured jaw or extensive flesh wound about the face it is always advisable to block off all nerve supply to the parts with a 2 % solution of novocain before attempting operation. Ail slough soft tissue is removed, but care is taken to preserve all parts of bone tissue. The fractured parts are assembled as best one can, and an impression of jaw taken in plaster. The point of fractures of the jaw is noted accurately, and the secured casts broken along the same line. Assemble the fractured parts of cast to normal occlusion, and on the new models make the inter-dental splints. In taking the bite and in adjusting the models to the articulator it is imperative to always use the face bow in order that the teeth may properly occlude when the splints are removed. This is especially true in case of the inter-dental splints where the mouth is to be held open. In selecting just the form of splint to use, many things are to be taken into consideration. If it is a simple fracture in either the mandible or superior maxilla and the patient is to remain in the Hospital for several weeks; not going to be transferred across any water where he would be liable to sea sickness, the Angle band method or the Gilmore wiring method may be used. Where the fracture is very simple and involving only one jaw the Gilmore position band splint, Hayes wiring method, Cryer's or Hulliham's swaged method or the Kingsley single arch splint Proceedings North Carolina Dental Society 17

may be used. Where the patient is to be transferred to some Conva- lescence Hospital, it is best to use the form of splint whereby the jaw may be held open and the open Gumming, Dorrance or Hulliham all answer the purpose especially well.

After the splint is properly constructed, the adjusting and holding of same in place is often a perplexing problem. Most splints may be

cemented in place, others just slipped over teeth, but in all cases it is best and safest to bandage the jaw up with a modified Banton bandage or by means of the adjustable Aiguris head cap.

It is always wise not to try to carry a case too fast nor to try to do all at one operaton; however, after the bone has begun to knit and the soft tissue to granulate, it will be safe to do the tissue or bone graft. The most successful and popular skin graft is the pediculated flap method. Freshen edges of wound by cutting away fibrous scar tissue. Obtain flap, about one-third larger than area to be covered, from some area near wound, particular care being taken to see that the flap has an ample supply of arteries, veins and nerves, or else the flap will most surely slough.

In folding flap over or suturing it down in place do not draw it tight as the vessels may be closed or the part where sutured may slough. The area from which the flap is taken should be covered over by either under- mining the tissue and drawing it together or else by use of the Thurschs graft. The bone grafts are usually secured from either the rib or tibia. The first part of this difficult technic is to thoroughly prepare the area for the insertion of the graft, arrest all hemorrhage and see that the area is in a thoroughly aseptic condition. In securing the graft one must be careful not to handle the graft with the finger, and also that it is of the exact size needed. The graft is usually sutured in place by a cat gut suture, held absolutely fixed for several weeks. The modified bone and tissue graft is often made use of in a fractured mandible case. In these cases the tissue graft is secured from the neck and chest and the bone graft from the clavicle. Both tissue and bone is raised at one time and properly adjusted over the wounded area. In all cases of Oral and Plastic Surgery, great stress should be laid on the case of the patient's teeth and mouth while the fixed appliance is in place. It is also imperative that the patient be given proper diet, and that at regular intervals. After the bone and tissue grafts have thoroughly healed then comes the restorations of the parts which could not be restored by the above methods. The lost teeth and parts of jaw bones are usually restored by either fixed or removable gold or rubber appliances. Lost noses, ears, etc. are constructed to suit the individual case, and are adjusted in place by hooks, eye glasses or springs of different nature.

President R. M. Squires: We are coming now to an interesting part of our program. Without taking up any further time, I want to ask Dr. Wheeler at this point to present I 18 Proceedings North Carolina Dental Society

a service flag which our own Dr. and Mrs. Morrow have so kindly prepared for us.

Dr. J. H. Wheeler: Mr. President and Gentlemen of the North Carolina Dental

Society : There stands within about six miies of Greensboro a monument re-

cently erected to General Nathaniel Greene. Whenever I look at that monument or some similar memorial, my fancy travels beyond the in-

dividual to whose memory it was erected, and sees the spirit of the times that was actuating the men: The Spirit of Liberty and Justice. My fancy travels back to the time when this now great country of ours was composed of only thirteen colonies and these little colonies engaged in a

desperate struggle for freedom and liberty; and my fancy traveling still further back, sees the company of Pilgrims coming to these well nigh unsettled shores that they may have Liberty: liberty of thought and liberty to worship as they thought best. The thirteen colonies have expanded until they take in all the territory from the Atlantic to the Pacific and from the Gulf to the Canadian border and the Spirit remains the same. Liberty is just as sweet now as it was then and the Spirit has so possessed us that we want every man, every where, to taste of its sweetness as we have tasted, and to know its true meaning. Not only have the people born within the confines of our own country had this blessing, but they have come to our shores from the uttermost parts of the earth and we have taken them in and made them a part of us and have bade them drink freely of this wonderful cup. In the beauty of our own life and the freedom of our own thought we well nigh forgot that there existed a nation whose people did not have the same blessings until in August, 1914, the hordes of the Hun, born and bred in a spirit of militarism, lined up with their vassal, Austria, and that blot on the face of God's green earth, Turkey, broke their bounds and set forth on a conquest of murder, brutality, rapine and post graduate barbarity such as a decent world had never dreamed of. Would that I had the time to pay a tribute to Glorious Belgium, as she stemmed the tide of the onrushing horde with its forty years of preparation behind them, until France could gather together her pitiful army and rush to the rescue, while England was gathering her little three hundred thousand to throw into the conflict that was now raging—a conflict of millions of the best equipped and trained brutes that the world has ever seen against thousands of practically untrained men. But thank God, they were stopped; the noble manhood of the involved nations rushed to the rescue and poured out their life blood in defence of the right and that the world might still be a decent world in which to live.

Our own country kept hands oflf so long as was decently possible, in fact longer than a great many of our people thought was right, in view of the fact that Germany was prepetrating one outrage after another against us, a neutral nation, but finally the day came when even the for- bearance of our Christian president could stand no more, and we went Proceedings North Carolina Dental Society 19 into the conflict with the determination to stand by these other nations to our last man if necessary, that a just and an honorable peace might be established and that autocracies should perish from the face of the earth and that the Spirit of Liberty should dominate the whole world. The call went out for volunteers and the answer came from all parts of the country, from an ex-chief executive to an humble day laborer. The German Kaiser has found that he was mistaken when he thought that an American was either too lazy to fight, or too timid to fight, or too greedy to fight. The Spirit of '76 still lives and all that it needed was the stimulus to awaken it. This has been demonstrated by the response of the volunteers and the enthusiasm of the selective draft men. When the call for volunteers came it included the professional men and we have just cause to be extremely proud of our profession for the quota was filled in a few months and dentists still clamoring for admission. Even now the examiners are getting calls to know if it is possible to get into the reserve corps. A great many of those who volunteered have been called; some are in France, some are in the cantonments and some are at home with their commissions in hand waiting for an assignment. All stand on an equal footing as to patriotism and each one is represented on this beautiful flag that Dr. Morrow and his good wife have presented to us. Our hearts are grateful to them for this beautiful flag and the tender thoughts that prompted it, and I am sure that so long as this Society exists and a memory of this horrible conflict remains in the minds of men that their thoughtfulness will not be forgotten. As I look at this flag and count its stars I realize that each star represents one of our boys and one of your and my friends, so I breathe a prayer to the great Giver of Life that he will watch over them and give them courage and valor in conflict, and great skill in dealing with those who are wounded and broken, and, if it be His will, that they may be returned to us to do a bigger and a better work than before.

Dr. W. T. Martin, of Benson, N. C, in accepting the service flag for the Society, spoke as follows:

Mr. President, Ladies and Gentlemen:

The citizens of our sister State once said that an attack on Massa- chusetts is an attack on South Carolina. They made good. Many stars have been added to Old Glory since that memorable statement went into history until today they number forty-eight. Coincident with that fact our own banner gleams with forty-eight stars, a spokesman for every State in the Union, as it were, and they have said that an in- fringement on the rights and perogatives of mankind anywhere is an attack on the honor and integrity of the citizenry of North Carolina. They will make good.

Many of these we honor today are fighting America's battle with dental equipments, others are training to get at the Hun in a more direct way, namely, with the rifle, but in whatever capacity they fight they 20 Proceedings North Carolina Dental Society

will do it as best becomes an American soldier and together they will soon sing the songs of victory.

When Dr. Squires asked me to take this part of the program my first impulse was to decline, then recognizing him as my superior officer I saluted and tried to respond in the spirit that is pervading America today,

"I will. Sir." One of the great things this war is developing is recognition of superiors and obedience to their commands, service in other words, and this is going to play no mean part in bringing to an end this terrible conflict. Horrible as it is; altho stupendous amounts of money that stagger the mind when we attempt to comprehend them are being spent; notwithstanding the fact that homes are being torn asunder and hearts are made to bleed and the purest Anglo-Saxon blood of Americans is being shed on the battlefields of France, yet I would view it all from the angle of an optimist and see it as a blessing to humanity and not a curse for in connection with the development of this spirit just mentioned, it is establishing unmistakably, man's relationship to man and his relationship to his Maker teaching him anew the Divine injuction to "render unto Ceasar the things that are Ceasar's and unto God the things that are God's." No longer does he ask as did one of old "Am I my brother's keeper?" but rather "Am I my brother's brother?"

Dr. Wheeler, It is with genuine pleasure that I, on behalf of the North Carolina Dental Society, accept this beautiful service flag that you on behalf of Doctor and Mrs. Morrow, have so elegantly and eloquently presented. Dr. Morrow, you and your good wife long ago, greatly en- deared yourselves in the hearts of the members of this organization and yours is a place none other could fill but today because of this thoughtful, magnificent and patriotic act, we love you with a love that human lips cannot express. May the day dawn in the very near future when you will see these of our number back in our ranks again and the cause for which they fight fully vindicated. This flag means far more to us than the mere material value involved or the beautiful cords of which it is woven; it represents the glorious flag of the greatest nation in existence, a nation that was carved out of chaos with the sword of light and liberty and its flag baptised in the blood of our fore-fathers at Yorktown and Sara- toga and is defended today by these of our own number with their life's blood if need be, men who having gathered inspiration from the ideals and traditions of the past are proclaiming to the world in deafening tones with their allegiance, their loyalty and patriotism that the old fighting spirit of '76 and 1812, of Appomattox and Gettysburg, of San Juan Hill and Manila Bay still lives in defense of a flag that with the help of Almighty God and a just cause to fight for NEVER has kissed the dust in defeat and, thank God, never will.

Carry on, glorious flag of my country, side by side with the Union Jack of England and the Tri-Colored banner of France until the atrocities and outrages of brave Belgium have been avenged and Alsace and Lor- raine have been restored to the land of Lafayette, beloved France! Carry on until your silken cords have kissed the breezes on the other side of the —

Proceedings North Carolina Dental Society 21

Rhine and you have been unfurled triumphantly over the capital of the German Empire! Carry on until you have shed your effulgent rays of light and liberty over the entire German Dominion and the camp fires of freedom and democracy have with their fervent heart melted into nothingness forever the mailed fist and the hob-nailed heel of Prussian Autocracy.

The sacrifices these are making should inspire us to do our part, not our bit but our all. This war is going to be won in America or it is going to be lost in America. Our boundry line is no longer the great Atlantic under whose roar we sit today, it's the Hindenburg line in France and

that line is so curved that it includes every home and office in America. All true Americans are soldiers now whether or not the uniform has been donned. Not all can fight, not all can go to the battle's front and

if we should it would then prove disastrous for all, but we can work at home. We can conserve food, we can buy Liberty Bonds and War Stamps, we can contribute to the Y. M. C. A. and the blessed Red Cross, the ministering agents and guardian angels of humanity and civilization.

And if God in His infinite wisdom has seen fit to permit any to be rendered unable to fight or work, thank Heaven, we can still pray and would that that prayer might be that the God of Abraham and Israel and of Wilson and America may shield and guide and save our men. "Let's remember the debt we owe them, the boys who have gone away The sturdy lads in khaki, the debonier and gay The boys who have left the sunshine to cross the mine-sown sea. They peril life in deadly strife for you, dear friends, and me.

Deep in those sodden trenches beside the hell-swept plain They brave the choking gases, the shrapnel's deadly rain. The sleepless nights of horror, the death that sets them free. They suffer thirst and pain accurst for you dear friends, and me.

A living wall in khaki that stays the cruel foe. A living pulsing bulwark, a bucker 'gainst the foe.

Dear God, if they had failed us, but no, that cannot be. Those sons of light in stalwart might will fight for you and me."

Brave American soldiers! woe be to the man or group of men that seek to stand in your pathway in this day of high resolution when all the principles we hold dearest are to be vindicated and made secure for the salvation of the nations of the earth! You have inspired the world with a hope that no other troops in existence could shed, England and

France know it and Germany is fast finding it out. You with the dare and dash of a Canadian, the courage and stout heart of a Frenchman, the bravery and heroism of a Belgian, the strength and bulldog tenacity of an Englishman and on your own hook with a supreme contempt for German bluff and bluster have said GERMANY WILL BE BEATEN and we are looking to you to give to the kaiser and his horde of barbarous Huns a genuine taste of hell that they will never forget. 22 Proceedings North Carolina Dental Society

You have the biggest, hardest task ever given to a soldier but you are men equal to the task. The future of the world looks to you; the safety of your homes and loved ones depends on you; the faith of a hundred million souls is placed in you and you MUST NOT fail. It is you who have taken up the golden thread of a new doctrine, a new gospel, a new life and a new light that was given us by the Lowly Man of Galilee; the hope of Christiandom lies in you and you CANNOT fail. The strength of a man to defend his own surges on to victory through you and the light of a just God leads you on. ALL HONOR, ALL GLORY, ALL PRAISE TO THE GALLANT TROOPS OF AMERICA!

Dr. J. H. Wheeler read the following letter from Captain Lineberger and Captain Patterson:

Detachment Office, Base Hospital No. 65,

Fort McPherson, Ga., June 16, 1918. To THE Members of the North Carolina Dental Society:

Base Hospital No. 65, now in training at Fort McPherson, Ga., is

composed almost entirely of North Carolinians, and it should be a matter

of intense State pride that North Carolina will be represented on the West- ern Front by a modern thousand-bed hospital.

The dental department of this base hospital is under Captain Line- berger, of Raleigh, and Captain Patterson, of Wilmington. In the present emergency the government is able to supply only necessities of equipment, and while these are ample for routine work,

it is highly desirable that the dental department of Base Hospital No. 65 have for use in France many appliances for special work which cannot be secured through regular government channels. We are therefore coming directly to you, our professional brothers, with a request that our North Carolina dental society place at the disposal of the Com- mander of Base Hospital No. 65 a fund available for securing needed special equipment. We suggest that this fund be at least two hundred and fifty dollars. We would not come at this time with such a request did we not feel that this fund will greatly aid our dental work in France, and did we not believe that every member of the North Carolina Dental Society would welcome the opportunity to share in the great work before us.

In this connection let us cite the action of the Winston-Salem Rotary Club. The Commanding Officer of Base Hospital No. 65 requested the Winston-Salem Rotary Club to act as a committee for raising five hundred dollars with which to equip a band. Within forty-eight hours a telegram was received from the President of the Rotary Club stating that a check for five hundred and forty dollars was on the way, the whole sum having been subscribed in one hour by members of the Club. Such Proceedings North Carolina Dental Society 23 generosity on the part of a lay organization encourages us all the more to make this appeal directly to you. With greetings to each member of this Society, we are, Faithfully yours, Capt. Henry O. Lineberger Capt. George K. Patterson. Approved by

Maj. J. W. Hanes, Com. Officer. After the reading of this letter contributions were requested for a fund for special dental needs of Base Hospital No. 65, and contributions raised, with amount which the Treasurer was authorized to pay from the funds of the Society, made a total of S500.00. Society then adjourned.

EVENING SESSION, JUNE 20.

The Society was called to order at 8:55 P. M., by the Presi- dent.

Dr. J. Martin Fleming: A few years ago, a young man from Apex, N.C., Dr.P.L. Pearson,withdrew from the Society, paid up his dues and asked the privilege of withdrawing, and we allowed him to withdraw. He is now in an army camp and cannot get off to attend the Society, but wishes to join, and the Executive Committee recommended that he be received upon payment of S5.00 initiation fee. A motion made to that effect was carried. The Secretary read the names of the following applicants for membership, as reported by the Executive Committee, the applicants being elected after an adjournment of one minute: T. F. Ashburn, Liberty. M. E. Hoffman, Asheville. E. P. Spence, Greenville.

W. J. Doub, East Bend. A. C. Edwards, Lawndale. E. C. Choate, Sparta. President R. M. Squires: We will now take up the regular order of business, and I am sure that it will not be necessary for me to do more than just simply to say that we have with us tonight in first order on the program, 24 Proceedings North Carolina Dental Society

Dr. Albert H. Stevenson, of New York City, the Director of the course in Oral Hygiene in Columbia University, New York City. RATIONAL PREVENTIVE DENTISTRY Albert H. Stevenson, D. D. S. 576 Fifth Ave., New York City Mr. President, Members of the North Carolina State Dental Society:

I came from New York and I found the journey very, very warm, and I was under the impression that the temperature would be very

high down here. I found the temperature very comfortable, and if

there is any warmth it has been in the reception of the membership of the Society.

What I am going to say to. you is in the nature of a message, and

I hope you will not take it as a message strictly to North Carolina men, but a message to go out through all the world. The topic of my paper is Rational Preventive Dentistry. Incompatible as it may appear with the daily casualty list arriving from over seas, we are living in an era of conservation of man power. We as a nation are exerting every energy to the utmost to conserve and contribute to the health of the men at home that we might be better equipped to destroy the enemy abroad. The sudden plunging of the civilized world into the unexpected and unprepared for horrors of war has caused a reversion to type, and the medieval, yes, and even the savage rudimentary instincts of the races have again come to the fore. While the defenders of our side of the bitter struggle do not believe that "might makes right", even those of the most pacific tendencies now realize that the mightier will conquer. The most conservative know that diplomacy and persuasion, treaty and tenet have little or no efTect upon the progress of this war. "By force we must win," declares our President, and our entire people are fully awakened and are contributing to that force that we may be victors. What part has dentistry in this contribution? A dental reserve corps of over 3000 young volunteers, the naval and army dental corps, the host of dentists in the Preparedness League doing work for the National Army, and the gifts of dental ambulances, all stand as a record of which we might well be proud. But there is another phase of our professional service that has been given comparatively little recognition, and I am almost ashamed to state, is too often neglected in many private practices—the preventive side of dentistry-. The involved scientific theories of susceptibility and immunity to caries; the controversies over the chemical composition and quality of saliva; the reputed advantages of acid and antacid dentrifices or washes, all leave us in a quandary as to the proper value of preventive work. Time and research alone will solve these problems, and in the meanwhile it behooves us to formulate empirically definite rules and then to follow them. Proceedings North Carolina Dental Society 25

For instance, the statement "a clean tooth never decays," has been declared a fallacy. It is contrary to our daily observations that all

teeth, even if clean, will be free from caries. Yet, no one will deny that a tooth rendered clean by proper prophylactic treatment, and kept clean by the patient is less liable to decay. This gives us a good reason for evolving a technique that will thoroughly cleanse each tooth and for teaching a hygiene that will keep it clean.

The various forms of technique of prophylactic operations advanced would and have filled many papers and most of them accomplished the results desired. You can range from the wooden points of B. Holly

Smith to the saws of Hartsell, pick your star and hitch your wagon to it. The general practitioner should recognize this important part of his field and more earnestly apply it. If he is too busy he should have someone else do it for him. To send a patient out of the office without telling him a definite time to report for prophylactic treatment is comparable to a surgeon dismissing a patient without arranging for future dressings. Every patient should be placed on a time period basis for constant observation and preventive treatment. A system of notification to patients when they are due will be appreciated by most people and is the only way to get maximum results. A controlled patient is always the most satisfied one and a controlled practice is always the most enjoyable and lucrative one. States that have legalized the dental hygienist give the dentist an assistant that relieve him of all the foregoing, while keeping the field of operation still under his control. (A little later I will show you films demonstrating this.) But we have performed but half of the obligation where we have finished the actual operative work. We are told that the good Lord helps those who help themselves and we must assist our patients to help themselves by directing them how to care for their own mouths thoroughly, effectively and diligently. Considering the various types of individuals who present for our attention this is no easy matter. Allowance must be made for the naturally indifferent type as well as for the one who is so preoccupied with other affairs in life that a tooth and a dentist are considered respectively in the abstract as an affliction and the remedy. As a preventer of dental lesions the dentist is not recognized and yet this should be his enviable distinction.

History teaches us that pain or distress is the greatest stimulus to right living. Even the most incorrigible succumb to physical discomfort and mend their ways. We know that those who neglect their dental organs eventually suffer some degree of discomfort and this argument for better care of the mouth needs no further substantiation. Recent revelations of the effect of dental focii of infection upon the production of systemic disease have created almost as much interest in the lay mind as it has in the dental and medical professions, and has spurred to re- newed effort many of the indifferent. It is not difficult to get cooperation from our patients if we do a little educating of the woefully ignorant public. 26 Proceedings North Carolina Dental Society

Unquestionably the place to teach Oral Hygiene is in the school- room. The impressionable mind of the child grasps facts and he readily forms habits which he will continue through life.

With all due tribute to the dentists who have given lectures to school children and to those dental societies that have instigated active pro- pagandas in their own districts, would not results have been more permanent if energies had been directed toward the inclination of mouth hygiene as an integral part of the school routine? Spasmodic educational campaigns unquestionably serve their purpose in arousing a naturally lethargic public, but a real continual application of anything, be it a pre- cept or a hygienic habit, can only be instilled by repetition of instruction. Do you know just how the boys and girls of your town are taught hygiene of the mouth, by whom it is taught and what text books are used? As members of the profession to whom is entrusted the care of this portion of the human body, should not this subject give you some concern? With a view of getting authentic data I secured for the National Dental Association information from the superintendents of schools of a number of cities as follows: ( See table on page 27.) Proceedings North Carolina Dental Society 27

3 _l O oc o=3 o-i o X oM X

llJ

UJ o> X 28 Proceedings North Carolina Dental Society

It is very apparent that with but fifteen to ninety minutes per week devoted to the entire subject of personal hygiene, there is not much time allowed for the study of mouth hygiene.

As the first grade is the one at which simple hygiene is taught, and in the case of Boston, the kindergarten grade, the lesson must be short and graphic. The Tooth Brush Drill fulfills both these requirements and when conducted by count particularly impresses the child mind.

I would commend the dry brush drill as taught in Bridgeport, Conn., schools and the wet brush drill as taught in New York City, (the latter requiring especial facilities). Both are performed while the leader counts, the mouth being divided into sections and each section brushed separately. Every school in the United States should have drills of this kind periodically. Dental Hygienists are particularly qualified to teach these drills and where they have been at work good results are evident. Where dental hygienists are not available for the purpose, the teacher should lead, she having received her instruction from a competent dentist. In the training school the young teacher should be taught the approved method of brushing and how to conduct a Tooth Brush Drill. A careful review of the text books indicated shows a tendency of the authors to avoid detailed directions in the hygiene of the mouth. This is perhaps our fault as we have no standardized methods, but the

text is very meagre and in many cases the information positively incor- rect in the light of our modern knowledge. Boston, Bridgeport and New York City are utilizing special pamphlets which present the subject in an excellent manner, but there is no accredited text book suitable for children.

These factors are so very obviously within the field of preventive dentistry, that no one will question the right of the dental profession to their supervision. Many cities have so recognized the advantages of this supervision that dentists are serving on their Health Boards as well as on educational committees. By their influence these men have in- augurated reforms that already show definite results in their respective municipalities.

One of the first requsites is the adoption of a teachable hygiene by the dentists themselves. A ver>' meritorious hygiene may be very effective in private practice, but be utterly impractical to teach to large groups of children. Psycology has been defined as the science of consciousness. To the child mind this consciousness comes slowly and impressions must not be conveyed too rapidly or all is chaos. The method adopted must, therefore, have simple principles easily inculcated. Then, too, existing school routine should be given every consideration and efforts made to comply with rather than augment the present curricula. Rational suggestions are always appreciated by the authorities responsible for the physical welfare of our school children. It is exceedingly difficult to educate the educators and until they appreciate it the dentist must do the educating himself. It is quite natural that the average dentist (with emphasis on the average) should Proceedings North Carolina Dental Society 29 have considerable hesitancy about public speaking and men should be especially trained for this work. A study class should be formed to prepare dentists to teach Oral Hygiene. Such a class was very successfully conducted by the First and Second Districts of the Dental Society of New York. Lecture outline forms secure uniformity of presentation and yet ample opportunity for originality.

Notwithstanding the abuse that has been heaped upon it, the tooth

brush is the most effective implement of hygiene that we now possess. As with any other instrument a lack of our improper sterilization renders it a menace to health, but it is illogical to condemn it on this score. All tooth brush bristles come from the wild boar that roams the woods and fields of Northern Russia and Siberia from whence they are transported to the factory and cleaned and sorted. A magnified bristle presents three parts. The flag, the stem and the butt. It is the stem that is used for the manufacture of tooth brushes. Great care is used to prevent the loss of elasticity of the brush, for a lifeless bristle means a use- less brush.

Many authorities believe that the sterilization of the tooth brush is an unimportant consideration. They argue that as long as one person uses the one brush the germs are his own and therefore are harmless. In this argument a bacteriological principle is ignored—the rapid propagation of bacteria under conditions of heat, moisture and darkness. Bacterio- logical experiments prove that brushes used in removing debris around the teeth and then hung up in the air, show marked activity of bacterial growth.

Dr. William Letterer of the Vanderbilt University of the State of Tennessee, made the following experiments: To test the germicidal power of formalin fumes (formaldehyde gas—40% in water). The tooth brush was rendered sterile by superheated steam (autoclave). The sterile brush was dipped into pure culture of streptococcus pyogenes, and was then returned to the receptacle to be acted upon by the formaldehyde gas. Three other cultures were treated in like manner, and in every instance double controls used, positive and negative. The result was that complete sterilization was effective in less than an hour's time. By drying the brush with the bacteria adhering to it the effectiveness of the sterilization was greatly impaired. The above results were obtained by using only the full strength formalin. No dilutions were used. The question as to whether it would be too irritating to the gums can be answered in the negative if the brush is rinsed in water before using. An ordinary preserve jar will disinfect the brushes of an entire family if they are placed with the brush end up and the handles resting in the one-haK inch of formalin contained thereon. The simple expedient of thoroughly washing and sprinkling with sodium chloride is a partial disinfectant but is not as effective as the formalin.

The hygiene of the mouth of our soldiers and sailors is giving us much concern at the present time. A pathological condition of the mucous 30 Proceedings North Carolina Dental Society

membrane commonly called "Trench Mouth," is now engaging the attention of the British army dentists. It was first believed to be due to the prolonged diet of canned good, but is now attributed to unclean mouths. Napoleon's assertion that "an army travels upon its stomach," can easily be translated to "An army travels upon its teeth," for without

proper mastication the usual army "chow" (as our boys in khaki call it)

is indigestible. As early as the Russo-Japanese War the importance of this was recognized and not only was each Jap soldier dentally in- spected and cared for but he was provided with a tooth brush at the

government expense. It is safe to assert that all the armies in the present struggle are given dental inspection as are the New Zealanders. Our boys are not given tooth brushes, but are supposed to supply them as part of their personal kit, and can purchase new ones and dentrifices at the various camps canteens. Under the auspices of the Y. M. C. A. the practical care of the mouth is presented to the men while training and efforts are made to have them follow the instructions given. They will probably not have an opportunity to use their teeth when they hit the Von Hindenburg line but they will be better able to use their bayonets. If you have impressed a fighter with the importance of caring for his mouth while exposed to the extreme vicissitudes of camp life you

have done your bit toward making him fit "to fight" and from present

indications it is evident that the physically fit are the only ones that can endure. The President introduced Dr. George M. Cooper, who read the following paper: PREVENTIVE DENTISTRY By George M. Cooper, M. D.

Director Bureau Medical Inspection of Schools, North Carolina Board of Health, Raleigh. Mr. President, Ladies an"d Gentlemen of the North Carolina Dental Society:

In the beginning, I want to express my appreciation for the honor conferred by the invitation to take a part in your meeting; and to assure you in the outset that I have not come for the purpose of preaching to you or at you. But I come to frankly and honestly discuss a program with you, which is of vital importance to every citizen of North Carolina present and prospective, but of especial importance to the children, who after all represent our State's greatest resource. Some of you have probably wondered what I mean by the term, "Preventive Dentistry."

I mean simply collective or community prophylaxis. I want to ask you to consider the matter exactly as I would ask a body of health officers to consider the prevention of typhoid fever for instance. necessity for prevention

It is an inviolable law of Nature that nothing ever stands still. A leaf is either growing or rotting. A plant grows or dies. Proceedings North Carolina Dental Society 31

I have been telling the mothers, and teachers, all over North Carolina that the age to begin taking a child to a good dentist is six months old.

A dentist told me a few days ago I was wrong. He said that the time to begin was with the child's grandmother at six months of age. He is everlastingly right. And so I hope every dentist here will agree with me that it is time to start a systematic educational propaganda. I shall not touch the field of pathology. I am not a dentist and so would make myself ridiculous before a body of experts. One thing, however.I do want to en ph-^.size as strongly as possible that nine-tenths of so-called indigestion is due to imperfect teeth with the resulting tooth diseases. The lee'h rorrpose the very gateway to the alimentary tract. The mouth ;- he beginning of trouble.

FREQUENXY OF DENTAL DECAY

An,ong he policy holders of the Metropolitan Life Insurance Com- pany in 1917 fifty-two deaths occurred from diseases of the teeth and gums. But the most significant part of this record is that seventeen, or one-third, were of children under fifteen years of age. Working in accordance with the law requiring a medical inspection of school children in North Carolina, the teachers made the preliminary examination for something like 175,000 school children during the last school year. Here are a few of the results taken at random: A school of 23 pupils in Lenoir County had 19 children reported with decayed teeth, average age 12 years. Only two had ever consulted a dentist. In Forsyth County a school of 51 pupils had 44 with decayed teeth; 23 of them or nearly half were 12 years old and over. 27% of them were over 14 years of age. All permanent teeth affected. Only three of them had been to a dentist. In Guilford County the health officer examined a school and found every child in it with decayed teeth 100% bad. Every child had a permanent tooth involved. Less than 10% had visited a dentist during their life time. In an examination which I had made myself for one of the large cities of the State, we found 1088 children out of 1638 examined, having remediable dental defects; 325 of them being over 14 years of age. These figures can be duplicated in any city, town, or school district in the State.

PROOF THAT THIS STATE OF AFFAIRS CAN BE PREVENTED

So much for the frequency of trouble. Now, can it be remedied and prevented in the future. A member of the Executive Staff of the State Board of Health told me recently that he took his two-year-old child to see a dentist, and the dentist refused to look in the baby's mouth, stating that it was not necessary to treat a child's teeth under 14 years of age. I am a living example of the fact that if something is not done vigorously and persistently for about half of all children's teeth before fourteen few of them will have a sound tooth of their own at thirty. Here is where the grandmother theory comes in. Numbers of people, 32 Proceedings North Carolina Dental Society owing to generations of bad heredity or wrong living environment, have blood and bone deficient in certain chemical elements, such as lime salts. To treat these people successfully every dentist must begin on the child soon after birth. Must have a good knowledge of physiology, chemistry and of food values; or what is better must have a physician consultant upon whom he can rely. At least two of the best dentists in North Caro- lina have informed me that they have the living proof that not one iso- lated case, but literally hundreds of them, from families of notoriously bad teeth on both sides, have been coming to them from babyhood for the past twenty years and who now have perfectly good teeth.

I know it can be done. Persistence and patience is all the requisite.

RESULTS OF NEGLECT OF TEETH

If this is not done, what? As said above, most so-called indigestion is one result. Cancer, tuberculosis, appendicitis, rheumatism, arthritis, diseased tonsils, stomach ulcer, heart disease, constipation, deformed mouth, physical discomfort, decreased productive capacity and general unhappiness, are some of the direct results to be expected.

NEED FOR DENTAL EDUCATION

The first essential is to get the public to realize these truths and get them to take action. I mean the people, the folks, the ninety and nine per cent that are out on the farms and in the mills and factories. But "How shall they hear without a preacher?" The facts must be continually and persistently presented to them. But how can this be done. Dr. Brady says that a "good dentist does not conduct a bargain counter." If a patent medicine man sells his stuff he advertises—and lies— If a politician wants office, and he always does, he goes out and asks for votes, and buys and steals what he cannot otherwise get. But a physician and dentist cannot go out and ask for patients. Their advertising must always consist of a job well done when the patient comes. But the rub is getting the patient to come at the right time if at all.

A PLAN OF CAMPAIGN

We have already shown that at least 95 out of every 100 persons in North Carolina over six months of age need dental treatment. We are equally sure that in all matters of this kind the only strategy worth while is to begin on the children, especially the group masses of school children. We have worked out a plan by which we propose to begin this year the oflFer of free dental treatment of a limited class to school children regardless of social or financial standing. We already have this work started in one county, and it is taking the combined efforts of the State and county health departments and the dentist to get the people out to take advantage of free treatment. But that is exactly what we expected, for visiting the dentist heretofore has not been a popular pastime. If the present activities of the State Board of Health had been put into Proceedings North Carolina Dental Society 33

effect suddenly ten years ago we would have been mobbed by the profession and the public. Now with the assistance of the dental profession

we hope to begin just such an educational propaganda. I had the privilege of helping direct the first great campaign in 1915 against typhoid fever. And the same methods that got 52,000 people vaccinated by our

force that summer will get 5,000 children treated by the dentists, if we have the same support from the dentists we had from the physicians in that effort. We are proceeding on the principle that you gentlemen have failed to get the Mountain to Mahomet and so Mahomet must go to the Moun- tain, that is the people. The plan is strictly ethical. We pay a young dentist a small salary, send him out in the country with the health officer, with a folding army chair and let him do dental work among the people. No expensive gold or bridge work, etc., will be offered, but the simpler forms of treatment, which in the case of amalgam fillings will last a lifetime. This work in the summer is to be followed where possible by the installation of a permanent dental infirmary at the county seat town, to be open throughout the year certain hours each week, free to school children. This is bound to be a success, because it is founded on fun- damentally correct principles. We expect to make mistakes here and there of course. We will have difficulties and obstacles to overcome. In the past there have been many efforts in North Carolina to get at this proposition, but every case so far as I can find out resulted in failure. We shall, of course, profit by those mistakes. Those efforts failed chiefly for two reasons. First the dentists offered their services free, and second, they proposed to treat only the children of the poor. Both propositions were radically wrong. In the first place dental work like any other public health question is worth paying for as a public proposition, and in the second place, whenever you start out to divide people into classes and card-index a proportion of them as indigent, you are out looking for trouble. This work is not one whit less a public health necessity than typhoid vaccination or giving free hookworm treatment. Now suppose, in our typhoid campaigns we had sent out notice that treatment would be given free to the poor, and the others could get it by going to their private physicians' office and paying five dollars for it. Would we have vaccinated 52,000 people the first summer? No, we would not have seen a dozen. We made our effort then to get the richest people in every dispensary district to come first, they came and so did the rest. This is exactly what must be done if our dental campaign succeeds.

LOGIC OF THIS PROCEDURE

Now the logic of this method is as plain as daylight. Every big man in the medical profession was quick to see it when we began a few years ago. We had a few physicians in almost every county to protest that we would ruin their private practice. These same men look silly now when asked about it. Why? Because the work was educational and the physician is now called on oftener and at a time when he can accomplish something and when the patient is able to pay him for his services, and 34 Proceedings North Carolina Dental Society

not simply called in to sign the death certificate. Some dentists will object, but they, with living material in North Carolina sufficient to keep busy ten times the number of dentists you now have for a lifetime, cannot fail to see the good logic in any plan which helps make a dental convert of our a young school child; and therefore assures to some dentist a patient for life, which would otherwise go to the country physician for treatment or extraction when suffering with toothache. COOPERATION BETWEEN MEDICAL AND DENTAL PROFESSIONS

Some of the most important requirements for the success of this work, as well as some of the best results to be expected, is the necessity for closer cooperation between the physician and dentist. In a recent issue the Southern Medical Journal says that "There should be a reci- procity in references between the kindred professions of medicine and dentistry." And "It would be a matter of guess work to place an estimate upon the lives that have slipped into early oblivion because of the absence of this essential affiliation of kindred sciences."

SUPPORT OF LEADING DENTISTS AN ABSOLUTE ESSENTIAL

Unless we have the sympathetic, unselfish, enthusiastic support of all the leading men in the dental profession our work will be a failure. It is true you will be building the bridge for those who are to come after you. But "The works of God are fair for naught. Unless our eyes, in seeing. See hidden in the thing the thought That animates its being."

DIFFERENCE BETWEEN TRADE AND PROFESSION

I hope I may be pardoned for calling attention to the young graduates especially, that every young dentist, no less than every young medical graduate, cannot remember too often that there is a world of difference between a trade and a profession. Dentistry is a profession. The tradesman asks how much can I get? The professional man, if he be true to his heritage, must ask what service can I render? If we would be successful in treating school children and get the great mass of people to grow up to the "dental habit" early, every dentist must make it an invariable rule not to inflict pain unless it is impossible to avoid. One big reason why dental propaganda is hard to make popular, is because of the morbid fear of pain. And I am convinced that the dentists themselves are largely to blame for this attitude. I recall that several years ago I had a troublesome tooth, as usual, and consulted my dentist friend. He is a splendid dentist, good man and loyal friend, but professionally cruel as a German. He looked at my molar, and bluntly stated that the nerve must come out; and suiting the action to the word, he placed his instrument and with a mighty blow of the hammer pretty nearly killed me. Oh yes, he got "the" nerve and "my" nerve too. Trouble was it would have taken fifteen minutes of his time to Proceedings North Carolina Dental Society 35 have obtunded the nerve terminals and he was in a hurry to go home.

Now, I hold that such an act is criminal, because there was no necessity for inflicting pain. Give me my chance of going back into his chair again or going over to the big electric chair at the Capital, I would take the latter without a quibble, because death would be mercifully inflicted. Patience and tenderness are the prime essentials necessary to succeed with school dispensaries. But it is well worth all the efforts. REWARD

If this plan of work succeeds the reward to the dental profession will be great, both materially and otherwise. The practice of every man will increase in just proportion to his ability. You will have the satisfaction of knowing that you have placed your profession on a plane of great serv'ice to all the people. You will see in the years to come a material decrease in the death rate from many easily preventable diseases, due directly to your efforts. The sum total of human happiness and prosperity will be greatly agumented. But your greatest reward will be the conscious knowledge of a duty well done. Dr. Stevenson: One would almost believe that there was collusion between Dr. Cooper and myself in that he has brought out this proposition and localized in such a way the very things I wanted to bring before you. The pitfalls that are open in New York and in other states are open and yawning for you. And this afternoon I had a talk with him and he is going to profit by the experience of others.

There is only one thing about it and that is that this thing is so big that if all of us left this meeting and devoted our entire time to it, giving up our practice, we would not make a dent in it. Now if we take a number of young dentists, a few graduate dentists, you have to pay them a decently respectable fee, and you can't secure enough money unless the State of North Carolina is very rich and very generous. You have got to come to the dental hygienist in North Caro- lina. Now the dental hygienist is not an experiment. There are five states in the Union, New York, Maine, Massachusetts and Minnesota, which have had this work for several years, starting with Dr. A. C Fones, of Bridgeport, Conn. With him it was a vision. It is a vision no longer, and that is that young women may be trained to practical work, devot- ing every morning, we will say, for a year to prophylactic work under the instruction of a periodontist. Those young ladies are qualified to do prophylactic work better than the average dentist is qualified to do it. I am talking about 36 Proceedings North Carolina Dental Society

prophylactic work on children. Now as an adjunct with this, or as a supervisor over a body of them to go out over the State, have your dentists. You will find a child six years of age with very few cavi- ties in the permanent teeth. But starting with the six year molars among the kiddies, the amount of money needed

is so very great that you will not get it. Temperamentally, there is something about a woman with children, and as a rule men are not as competent to handle children as women.

Gentlemen, it has been proven by what I heard this afternoon from Dr. Cooper and what he said tonight that the

thing is liable to fail in two ways, that you are going to go into this thing and to handle it strictly by dentists. To try this thing with dentists, there should be some hesitancy.

Start it that way if you want to, and I make this prediction that you will not do it very long. To do it in the best way, you have got to employ hygienists in this way. A dentist cannot leave his office and do the work. His work is actual work and he has to do work with his hands. The only way is to engage young dentists. We have a school in Columbia, school up at Rochester and a school up at Forsyth. We find young women graduates from college applying to take this course of hygienists. We have wives of dentists, numerous dental office assistants. We have found even in the Borough of Manhattan, where the worst conditions of illegal practice have been going on

for years, we find no trouble at all. So if you fear that phase

of it, you need have no fear. Dr. Squires: While waiting for the lantern, I would like to state that our former custom of appointing the Pub- lishing Committee at the close of the meeting was not quite as satisfactory as appointing them before the close of the

meeting, so I appoint as our Publishing Committee this year, Dr. Whitfield Cobb, who is also our stenographer.

Dr. Watkins: I would be glad if Dr. Stevenson would give us an outline of the New York State law on oral hygiene. Dr. Stevenson: It was an amendment to the dental law—two amendments. The second amendment was, that a dental hygienist shall be a young woman, shall receive a Proceedings North Carolina Dental Society 37

full year's course of training in a school or college that is certified to by a board of regents, and that one-half of the practical work shall be under the supervision of a licensed dentist, that the school or college must have a dental infirmary, that the dental hygienist's practice shall be limited to the removal of stains and secretions on the exposed surfaces of the teeth, under the supervision of a licensed dentist.

Dr. J. Martin Fleming: This morning we voted to change Dr. Sherrill's name from the active to the honor roll on account of his health. He has sent the Treasurer his dues for another year, and I move that the Treasurer be authorized to refund these dues on account of his being transferred to the honorary list. This motion was duly seconded and carried. Dr. Everitt: I heard from Dr. Sherrill a few days ago, and he requested that his name be placed on the honorary roll, and requested me to give his love to the members of the association.

Dr. J. Martin Fleming: I have a little resolution I would like to introduce in connection with Dr. Cooper's paper. As Dr. Cooper says, he is going to find dentists all over the State to oppose him, and I want to introduce the following resolution: Resolved that the North Carolina Dental Society heartily endorse the plan of the State Board of Health, as outlined by Dr. Cooper, and that we pledge him the loyal support of this Society. This resolution was adopted by the Society.

Dr. Cooper: I hope you will allow me to thank Dr. Fleming for the resolution and every man here for that vote.

Dr. Everitt: I want to thank Dr. Cooper for what I might term the remarkable paper that he read here this evening and to say to the convention that I endorse it most heartily. It is one of the best papers I have ever heard read here. It is hewing right to the line, and I hope that every member here will endorse it.

Dr. Arthur Fleming: I would just like to say that I don't know a paper read in our Dental Society since I have been a member that I take more interest in discussing than 38 Proceedings North Carolina Dental Society

this paper of Dr. Cooper's. This proposition that he has presented to us so forcibly has been a hobby of mine for quite a number of years. When I first came from college,

it was my privilege and pleasure to go into a number of schools and the college situated in Franklin County, and,

as I thought, do a wonderful work in delivering dental lectures on oral hygiene. I found that this did not carry. It did not have the force that something else should have. And I realized at this time, more than fifteen years ago, that there was something lacking and it was this thing that we have seen on the screen tonight—that you can't tell people things, you have got to show them, and at this time I decided to save from my practice conditions which were abnormal.

I am not a Jew and do not live in a Jew's building, but I have been the victim of four fires; but I have saved a few specimens, and in the last few years I have undertaken a work, and that work is this: It is impossible to reach a great part of our population in the rural districts, and it is a little idea that I have evolved and I don't claim any credit

for it, because maybe dozens of you are doing the same

thing and if you are not doing it, I want to ask that every one of you do it before the next meeting.

I have thought of this plan and I now have it in operation. In Franklin County we have ten townships, and in each one of these townships we have so many school districts; and I have obligated myself to take three girls from each school in each district and to teach them the care of the teeth;

and I have a lantern and slides and am now doing that in Franklin County. These girls come to me, and I give them a

little demonstration and a talk, and it is my hope to educate three girls in every school in Franklin County by the fall.

Now I propose not to graduate these girls, but to give them a little certificate as home hygienists, only whenever they obligate themselves to teach three others as I have taught them; and those three that they are to teach are to come to me or to some other dentist in the county and show that they are qualified as home hygienists; and when they have done that the girl gets a diploma as a home hygienist. Now there is one thing that I think will be accomplished. We will have teeth talked from the time that school opens Proceedings North Carolina Dental Society 39

until it closes. I take them from nine to fourteen years old, and these children who think they are skilled with instruments will talk to other children who are not skilled with instruments; they will talk to them and show them what they can do. And it is my purpose to have them hold clinics. These girls of today will be mothers of tomorrow.

I can venture this assertion: That there won't be five men in this assembly hall whose wives can brush their children's teeth. I have given this as much attention as any man, but I had been married five years before my wife knew how to brush her own teeth.

I am claiming no credit for this, and I want no credit for it, but I want every man in this convention to feel pride enough in his own county to take up this work and to try to make every child in every school in his own county a dental hygienist. The other things will come after they have learned this. There are other things that stare us in the face besides the preservation of the teeth, the conservation of everything in this world. Life is a process of evolution, and unless we teach our children and the children of those children to get back to the simple life .... principles that confront us, we will eventually be born a horsefish family with mouths like suckers. It is going to come soon, and the sooner it comes the better posterity will be. You can view the skulls of the prehistoric nations and you will find thirty-two well de- veloped teeth. I remember my first day in the clinic of the University of Pennsylvania, the patient I had had five teeth, and I thought what's the use to practice dentistry with only five teeth to work on. We will not only teach the children the care of the teeth, but we will teach the conservation of health and get away from breakfast foods and canned foods, but eat good foods and produce strong teeth. I want to see by the next year every man in this profession interest himself in the children of his county and teach them what he can.

I am glad to say that the county of Franklin is cooperating with the State Health Department and Dr. Cooper, and I am proud to say that the cooperation of the State Board is 40 Proceedings North Carolina Dental Society due to Dr. Cooper's efforts. The dentists of Franklin County—there are four of us—have volunteered to do this work for the school children. This can be done in every county, and there is no reason why every county and every school in it cannot have a dental hygienist. President Squires: I believe the purpose was to have these papers and talks discussed if there are any here who feel so inclined to do so.

Dr. J. Martin Fleming: It looks like the hour is getting late and we possibly will not have time for discussion, but somehow I feel tonight as I did this morning, to discuss a paper prepared by Dr. Stevenson and to discuss a paper prepared by Dr. Cooper is hard to do. They really have spoken the last words along their line in each case.

I would like to thank Dr. Stevenson for coming and for the message he has brought us and for his Fones slides. I wrote to Dr. Fones last fall and asked him to recommend a man who might show his slides and give us a talk along these lines. He wrote me to get Dr. Stevenson of New York. The Executive Committee would like to honor the Society by proposing for honorary membership: Dr. Albert H. Stevenson, 576, 5th Ave., New York. Dr. George M. Cooper, M.D., Raleigh, N. C. These gentlemen were duly elected honorary members. The society then adjourned. MORNING SESSION, FRIDAY, JUNE 21.

. The Society was called to order by the President. The Executive Committee reported the names of the following applicants for membership, who, after the adjournment of one minute, were elected:

P. I. Darden, Mt. Olive.

J. V. Davis, Concord. The following paper was read and illustrated with lantern slides by Dr. J. S. Spurgeon: THE NECESSITY FOR REMOVING ALL INFECTION AND PUS CONDITIONS FROM THE MOUTH

Dr. J. S. Spurgeon, Hillsboro, N. C. A few years ago the Mayo Brothers are reported to have said that the next great advance in the Science of Medicine would come through Proceedings North Carolina Dental Society 41 the Dental profession or from a Dental standpoint, this was quoted by most all the speakers, and writers, and published in all the journals throughout the land. Gentlemen, we are today living in the midst of the fulfillment of that prediction, and the indications are that we, the Dentists, are now doing and will continue to do more and more to conserve the health of our people, we will do more to relieve pain and sickness than could be done from any other standpoint, we will do more to prevent all kinds of chromic and acute diseases, and in many instances save human life. When we read or hear the statement made, that arthritis, aortitis, embolism, appendicitis, the kidneys, the liver, the skin, and in fact, the serious derangement of EVERY organ and every tissue of the body, may be and is often caused by infections originating in the mouth, do you understand that it is true, have you seen it demonstrated in your practice? If not, then I wish to emphasize the importance of looking for and demonstrating that these things do occur.

First I wish to quote in full. Press Bulletin No. 1, Series 1918 (re- leased for immediate use). records of insurance company show that fifty-two policy holders died during 1917 from dental disorders.

That death may be caused by disease of the teeth is shown in a statement just issued by the Metropolitan Life Insurance Company. During 1917 fifty-two deaths which were traceable to infections of the teeth and gums occurred among its Industrial policy-holders. Diseases of the teeth cause death through the complications which set in. The tooth troubles in these fatal cases led to blood poisoning, inflamation of the membrane of the brain, inflamation of the middle ear, decay of the bones of the jaw and head, and even inflamation of the lining of the heart, as well as serious derangement of the digestive system.

the deaths occurred at all periods of life

Of the fifty-two deaths, seventeen, or nearly a third were of children under fifteen years of age. Twenty-one of those between fifteen and forty-five, ten between forty-five and sixty-five, while the remaining four were among policyholders over sixty-five years of age. The condition is, therefore, especially worthy of attention among school children, even the very young ones. Infection at the ends of the roots of the teeth, so-called "blind abscesses," ulcerations, and pyorrhea, or Riggs disease were among the conditions reported in these fatal cases.

care of the teeth saves and prolongs life

Most of these deaths were probably preventable. If it were possible to obtain the full history of these cases, it would probably be found that lack of proper care of the teeth was the real cause of all of them.

Second I wish to quote in full a copy of a death certificate on file in the office of Superintendent of health of Rowan County. 42 Proceedings North Carolina Dental Society

MEDICAL CERTIFICATE OF DEATH Date of death January 6th, 1918.

I hereby certify, that I attended deceased from October 1st, 1917, that I last saw him alive on January 5th, 1918, and that death occurred on the date above stated, at 1 A. M. The cause of death was as follows: Pyorrhea Alvealoris and Embolism of Brain. (Duration) 4 months. (Contributory) Chronic Nephritis. (Duration) 1 year. (Signed) B. G. Edwards, M. D. January 6th, 1918. (Address) Landis, N. C.

Third, I know no better way to emphasize these things than to cite a few of the many interesting conditions that have come under my own observation during the past few years, however, before doing so I wish to state that in so far as this disertation is concerned, I shall not go into the discussion of the pathology of, or of the particular organism that may cause certain diseases, however, I would recommend that you take this matter up and give it especial study, for in view of the work that is being done along this line by Dr. Rosenow and others, it is wonderfully interesting, and it will probably develop and lead to a definite course of treatment that will surpass anything that we now have at our command.

It is my firm conviction that when these organisms are better understood, we will be able to produce vaccines, perhaps antagenous vaccine, that will be a specific in many of these cases, just as we now prevent diph- theria and typhoid fever by proper inoculation. But for the present we can only confine ourselves to such treatment as WILL REMOVE AND PREVENT THE RECURRENCE OF ALL PUS CONDITIONS AND INFECTIONS THAT MAY BE FOUND IN THE MOUTH. And in the removal and prevention of these PUS conditions, strange, unexpected and wonderful things, often happen.

Case 1. Miss C . Pyorrhea. Trained nurse, age about 50, rheumatic and stiffness of the joints, swelling of the hands and feet, vitality lowered, six weeks after treatment all rheumatic pains and swelling had disappeared and her vitality restored to such an extent that she said, she felt like returning to her work with the same enthusiasm and interest that she used to have, one of the strange things that happened in this case was that on her neck just below the collar bone was a small benign tumor, not larger than a pea with a base about one-fourth inch long, the base not larger than a knitting needle, and another on the lower limb, of the same description, but much larger, at the time she reported (six weeks later) both these tumors were gone, she did not know when or how they went, the scar had the appearance of having been skillfully removed with a knife and the roots desected out from the base, perfectly and beautifully healed, about twelve months since the treatment and none of the symptoms have returned.

Case 2. Mr. L . Pyorrhea. Age 40, general health good, and a very strong and active man, for fifteen years had suffered periodically with acute rheumatism, completely relieved and no return to the present time. The strange thing that happened in this case was that for two or l-hree years the backs of his hands had become dry, hard and scaly, so ^hat the entire surface of the back of both hands were covered with scales, Proceedings North Carolina Dental Society 43

having the appearance of pellagra, gradually getting worse. This had gone to the extent that he refused to shake hands, and when in company would keep his hands behind him. In about two months time every appearance of these scales had disappeared, leaving no trace of what had been, no return up to the present time, two years.

Case 3. Mrs. W . Pyorrhea and five abscessed teeth. Age about 55, had worked very hard all her life, doing all of the house work, cooking and washing for her husband and three boys. A complete breakdown. Had been confined to her bed for some weeks, general debility, severe pain in lumbar region and under both shoulder blades, pain so great that she could not walk alone, and could not lie on either side, gradual improvement and twelve weeks after treatment she was again doing all the work, and expressed herself as feeling better than she had in five years. Three years since treatment, her health remains fairly good, and is still doing her work.

Case 4. Mrs. S . Pyorrhea and two abscessed teeth. Age about 45, had been diagnosed as ovarian and uterine trouble with continual indigestion, severe pain and swimming of the head, pain in the back, in both sides and under shoulders, had not walked more than a hundred yards in five or six years, and only then with a cane or crutch, the fourth day after treatment she walked more than a mile and up a flight of steps without any aid. It is now about three years, the ovarian and stomach troubles have not cleared up, but she is much improved, and is able to do her own house work.

Case 5. Mrs. M . Pyorrhea and three abscessed teeth. Age about 56, chronic invalid, rheumatic and partial paralysis of the right arm, could not raise her right hand above the wrist, and could not grasp anything with it, six weeks after treatment the arm had a free movement, she could extend it above her head, and said she could milk a cow as good as anybody. About three years have passed, her health is fairly good, and no return of the paralysis.

Case 6. Mrs. W . Pyorrhea and three abscessed teeth. Age about 45, general debility and loss of flesh, headaches, pain in the eyes, with defective vision, had been diagnosed as ovarian trouble. Treat- ment that she was able to get gave little or no relief. Oculist consulted, and glasses tried but they did not correct the vision or relieve the pain in the eyes. After being relieved of an acute attack of the ovarian trouble was referred to me, a few months after treatment her general health was restored, vision restored, and no need for glasses.

Case 7. Mr. C . Pyorrhea and one chronic abscess. Age about 33, Acne Rosacea, or commonly known as bumpy face, in the most exaggerated form, this condition had prevailed for years, the face being so red and covered with bumps that it was badly disfigured. A few months after the infection was removed from the mouth, all bumps and postules disappeared, leaving the skin a normal and healthy color, with only a few slight scars. He gained 35 lbs. in weight in a short time. Two years, no return of the symptoms and health splendid. 44 Proceedings North Carolina Dental Society

I will now show you a few slides, and call your attention to the necessity of curetting after extracting teeth that have had chronic abscesses of long standing.

Case 8. Mrs. S . Age about 40. One abscessed first molar, (throw picture on screen) with gold crown that had been placed there 15 or 20 years and had never given any pain. She is a perfect type of development, and of health, but for the past few years has been threat- ened with a nervous collapse, she had been to the best diagnosticians in this and other states, she had spent some time in a hospital, and with other things tried the rest treatment, apparently all that could be done gave little and temporary relief, about twelve months ago this tooth was extracted, but we did not curette for the reason that there was no Novo- cain available at that time, after the extraction there was a decided improvement in her general conditions and a gain in weight, about two months ago the old symptoms began to return, nerv^ousness and vitality lowered, at that time we had this picture made, and we found an infected area, bloody serum exuding from beside the first molar and bicuspid, which we believe to be the most virulent form of infection, this was curetted recently, and there has not been sufficient time to note any marked improvement, but we are confident that it will be a complete recovery.

Case 9. Dr. H . Age 48. Granuloma involving the apex of two teeth of many years standing. This is the gentleman that was operated on by Dr. Silverman before the Society at our meeting last year in Durham, and is perhaps the most interesting of all that we have, he has been a remarkably strong and healthy man with the exception of occasional sick headaches, that were very intense and lasted for 24 to 48 hours, for three or four years he had frequently called my attention to an uncomfortable feeling over these two teeth, by the side of the nose and at the infraorbital foraman, with a small ulcer of several years standing, just inside and on the floor of the nose. This ulcer in the nose had been treated by a nose and throat specialist, but it always returned. Upon examination from time to time we could see no cause for the trouble and dismissed it with the statement that it probably would not amount to anything. As time went on his general health began to decline, with loss of energy and activity, and with slight pain and swelling of the ankles. At that point we had this picture made (throw picture on screen) and the operation that many of you saw. In a short time the pain and swelling had disappeared from the ankles, and a remarkable improvement in general, with gain in weight and activity. There followed this an unusual amount of hard work and mental stress, so that January 4th, of this year, he suffered a complete breakdown, he lost all interest in the affairs of life; in fact, living was a burden, and he expressed himself as not caring how soon the end might come. Diagnosis revealed pus, albumen, casts, and blood from the kidneys. Strict diet and treatment was followed with some improvement, but not at all satisfactory. At this point it was suggested that we have another picture of these teeth made. This is the :

Proceedings North Carolina Dental Society 45

result: (throw picture on screen). It shows that there was a small necrosis left in the alveolar process posterior to the roots of these teeth back of the granuloma. Another operation was performed, removing not only the necrosis as shown in the picture, but a large area surround-

ing it that might be infected. After this operation he gained five pounds the first seven days, and no pus, albumen, casts, or blood, have been found • in the urine since two weeks after the operation, with marked improvement in general health. I submitted these statements to him for cor- rection and he asked me to say in addition to the above, that since the operation not a dose of medicine had been used and that his general health in some respects was better than it had been for years, that for some time the skin had been dark and brown and lifeless, and that now it is clear and soft, with a healthy glow. This case like many others emphasizes the fact, that apparently the slightest and smallest infections in the mouth may cause the greatest, most serious, and disastrous results.

Case 10. Mrs. L . Age about 35. Acute rheumatism, confined to the bed for some weeks and suffered intensely. She was treated by the best and most skillful physicians with no relief, and for that reason was referred to me. We had the entire mouth X-rayed and found this tooth (throw picture on screen) which we extracted and curetted, the relief and improvement was very slow, but continued gradually for ten months when all the pain had disappeared, and today she walks as nimbly as when a girl. This is another case of apparently slight infection that caused serious trouble.

Case 11. Miss B . Age 33. (Throw picture on screen). Pyor- rhea with little or no deposits on the teeth, gums swollen and badly in- flamed, large quantities of bloody serum exuding from the gums and from around the teeth. The condition was so bad that she had to ex- pectorate every few minutes during the day, and at night while asleep

it was estimated that as much as a cup or more of this bloody serum would run out of the mouth, this was accompanied with sick headaches and lowered vitality to such an extent that life was a burden, three teeth were extracted the remainder treated. (Throw picture on screen). This picture made twelve months later shows the results, with no return of the pus.

Case 12. Mrs. R. Age about 32. (Throw picture on screen). Pyorrhea and two abscessed teeth, for some years had suffered with sick headaches, and painful menstruation, staying in bed from 24 to 36 hours during each period, married for ten years, barren. 18 months after treatment (throw picture on screen showing patient with infant.)

Case 13. Mr. S . Age 54. (Throw picture on screen). Pyor- rhea and one abscessed tooth of long standing, loss of appetite, enemic, face drawn, lost manhood. Six weeks after treatment, (throw picture on screen) "The smile that won't come off." Dr. Harry B. Johnson, of Atlanta, Ga., read the following paper 46 Proceedings North Carolina Dental Society

IONIZATION AND ROOT CANAL FILLING Dr. Harry B. Johnson, Atlanta, Ga.

Before I start on reading this paper I simply want to say a few words

about how I enjoy being here with you gentlemen. I have been in North Carolina but a few very times, but each time has constituted a great deal

of pleasure to me and I appreciate the invitation to come over and read the paper and give a clinic for you. 'Ionization and Root Canal Filling". Such is the title of my paper as given in your program. To carry there various procedures forward in their logical sequence however, it will be necessary for me to depart somewhat from this title. The first thing I wish to stress is the incalculable importance to the patient of proper treatment and filling of the canals of every non-vital tooth. This has been brought out very forcefully and frequently by

practically all of our recognized leaders, but I will unhesitatingly say that not one per cent of the members of our profession have as yet, a real or even approximate conception of the absolute necessity for protecting our patients in this respect to the absolute extent of our ability. Most of us appreciate the necessity for disposing of chronic abscesses of the pus-

producing type. It is of fully equal importance to dispose of the blind periapical, or alveolar abscess—or to name them more properly—granu- lomata. Just how important this is, we are now just beginning to find out—that is, those of us who keep in the closest possible touch with the few great minds which are daily delving deeper into this great problem. Those who have not the opportunity or the desire to do this, merely know of the existence of such a problem. A more universal and intense interest in this must be generated. In as much as such a tremendous number of the most obscure, and for patient, dentist and physician, most unpleasant ailments with which humanity is afiflicted are either primarily or secon-

darily caused by periapical infective foci, we as dentists owe it to our profession, our patients and to ourselves to delve into this subject with all of our ardor and enthusiasm. If it were possible for each of us to see pass in review before him each of those patients whom our ignorance has deprived of those finer qualities of health and happiness, shortened their periods of usefulness and term of life, what an awakening there would be?

Understand I am not laying this to our door as criminal negligence, for the day of knowledge is just now beginning to dawn, but our knowledge is now such that it soon will be criminal negligence if we are not able to inform our patients fully and scientifically of the dangers of non-vital and infected teeth, and be able to treat them properly should the patient so consent. Though we are all doubtless more or less familiar in the abstract with most of the derangements caused primarily by these nests of streptococci, let us review them again, and possibly add some new ones with which you are not familiar.

Probably the most common is arthritis, or inflammation of one or more joints is one of its numerous forms. How horrible is arthritis —

Proceedings North Carolina Dental Society 47 deformas in which the joints become enlarged, distorted and ossified and yet how common? Neuritis, or inflammation of some trunk nerve. The patient's usefulness, efficiency and general physical welfare is de- stroyed in direct ratio to the severity of this attack.

Endocarditis. This is probably the form which results in more actual mortality than any other secondary form of oral infection. The writer recently heard Dr. Thos. B. Hartzell, of Minneapolis, state that federal statistics prove that heart disease claims more victims annually than tuberculosis and that 90% of these cases originate from oral foci, includ- ing alveolar abscesses, pyorrhea and infected tonsils. Think of it; more people are dying annually from only one of the many forms of disease which originates in the mouth, and which we should be able to diagnose and cure, or cause to be cured, than are dying of the universally dreaded disease, tuberculosis.

To continue with the list however, we have myocarditis, inflammation of the heart muscle; arterioschlerosis—hardening of the arteries; iritis; inflammation of the iris of the eye; nephritis, inflammation of the kidneys—and it is now stated by some authorities that some cases of Bright 's disease are believed to have been traced to periapical foci. Certain cases of chronic appendicitis have been definitely traced to the same cause, and as definitely cured. Burning or itching rashes on any part of the body, particularly the feet; high blood pressure, low blood pressure, gall stones, bladder ulcers, gastric ulcers, stricture of the ureter, atrophy or hypertrophy of the delicate structures of the inner ear, producing a progressive loss of hearing; tonsilitis and others which I may have overlooked are included in the list. As formidable as this list now is, it is the humble opinion of your essayist (if I may venture a personal opinion) that it will be ver>' heavily added to. If this slow, low grade and insidious type of infection found in periapical foci can cause major lesions of as active and powerful an organ as the heart, what may it not cause either primarily or secondarily. We know that the toxins from these foci are being taken up by the lympatics every minute of the day and night resulting in the continuous infection and impoverishment of the blood stream, that great fluid organ from which ever>' other organ, every tissue, every cell must draw its nourishment—its very life. A case in my own practice recently may (or may not) illustrate this further. Patient, a woman of approximately 30, married, two children, pronounced blonde. Symptoms, anaemia, marked loss of weight, strength and energy. Had been menstruating continuously for about 3 months. A radiographic examination showed 3 non-vital teeth, two of them with quite large rarified areas. All of them were carefully opened, ionized and filled. At the same time that I began treating her, her physician changed his treatment. Thirty days after completion of the dental treatment, she returned for examination and stated that about 10 days after treatment was finished, menstruation ceased, and up to that time, she had gained 15 pounds and was very evidently greatly improved. She again returned 30 days later; physical condition not so good, and 48 Proceedings North Carolina Dental Society stated that she had had some return of the trouble in spite of the medical treatment. I may be wrong but I attribute this to a reinfection. Two of these teeth were so seriously infected that I was very doubtful of being able to save them, but as one was a cuspid, was very anxious to do so.

She is soon to return again and if she still shows symptoms of reinfection, extractions will be made followed by a thorough curettage. The fact of the return of her trouble under the same medicinal treatment she was using at the time of her relief leads me to believe that her relapse was due to reinfection of the granulomatous areas. It is only by the careful observance and tabulation of such cases that we shall ever be able to arrive at definite solution of the many problems embraced in this subject.

The problem of opening and filling pulp canals. This is, in the opinion of the essayist, the foundation upon which our results shall abide or fail. Granting that we have gained such access to the focus of infection as will enable us to destroy it, and granting that we have so disentegrated the granulomatous tissue that nature is able to destroy the bacteria (for neither ionization nor any other method we now have does this) if all canals are not perfectly filled, and every foramen sealed, we have no right to expect that tooth to remain immune from future infection. There is no other operation in dentistry that can compare with this in difficulty and delicacy. For bear in mind that we are not dealing with ONE foramen to the canal but with two, three, six, or even eight. Now if it is so important to fill one of these why is it not of equal importance to fill each of the others. A canal may be of microscopic calibre yet be a veritable St. Regis for streptococci. Can these accessory canals be opened? Not more than one or two to the root. Can they be sterilized and filled without being opened? Unquestionably—thanks to that grand old pioneer whose fame will ever increase as the years roll on—Dr. John R. Callahan. It is the opinion of the essayist that the "Callahan method" is, and will remain so for many years, if not for all time, the ONLY method whereby every canal regardless of size, curves and angles, may be perfectly filled. I have proved that chlororesin is of such a penetrability that it will even penetrate and fill with resin the spaces between the enamel rods. This has been proved on dried teeth which when soaked in cloro-resin become so saturated with resin that they can at any time thereafter be cut with the largest cross cut fissure burs or ground with the coarsest stores without using water, and the enamel will not chip or break. We do not rely on this resin however, to fill any but the exceedingly attenuated canals. The other may all be filled with guttaphercha—provided we have not enlarged any one foramen so large that under pressure all of our filling material will escape through this one great highway of least resistance. I do not believe that the natural size of any foramen should ever be intentionally increased. Where we have one main apical foramen which is of considerable size—so large

that it can be forcibly penetrated by a fine Kerr pulp canal file, we should first PLUG that, then force our chlororesin—percha into the minute ac- Proceedings North Carolina Dental Society 49

cessory canals. It is a grave question if an infected tooth so treated and filled will not be restored to normal by the unaided forces of the body.

I have not yet felt justified in experimenting in this on my own patients, but have always ioniz:d before filling. Let us now get to the real meat of my subject—how to properly open,

sterilize and fill pulp canals. Generally speaking, the only canals which are at all difficult to open are those which have contained no pulp for a number of years, or those in which the pulp had been in constant state of irritation for a number of years until deposits of secondary dentin have

almost entirely obliterated them. I have frequently found them of a size that could be compared to a single fibre of cotton or silk. That

sort is indeed difficult to open and may with safety be done only by constant and long continued use of dilute sulphuric acid, for in those instances

no instrument will even detect the canal, much less penetrate it. In opening the average canal, my technique is to place 30% sulphuric acid in the pulp chamber and begin working in very cautiously and slowly a XX fine Kerr pulp canal file; about a quarter turn and a partial with- drawal constituting each stroke, which very effectively opens, removes debris and carries in the acid. Do not attempt to use any form of reamer, G-G drills or anything whatsoever except a canal file, a smooth broach or a barbed broach at this stage. I have named them in their order of effectiveness. G-G drills may be used for giving the opening a funnel shape but should never be sunk deeper than the length of its head. As

long as the point of the file binds slightly at each stroke we know that

we are following the true canal, but when it ceases to bind, or hang, good-night—we know that we have either gotten out of the canal into a "blind alley" of our own creation, or we have struck a constriction so

small that the needle point of the instrument cannot even feel it. In

this case, we withdraw the file and assure ourselves that it is the smallest

one we have; then bend the point of it very slightly so that if we have merely gotten out of the canal at some curve in its course, we may find

it again with the bent point with which it is much easier to follow a curve than with a straight instrument no matter how flexible it may be. It is my constant practice to keep my files and pathfinders bent to conform to the curves of each canal throughout its entire preparation. It has been my experience that when a canal becomes so attenuated that the point of a XX fine Kerr file will not bind in it at the point, that no pathfinder or other smooth broach will penetrate it. These are cases which require the careful and delicate work to avoid a perforation. We then

fill the canal with the 30% acid and seal it in until one or two days later.

(It will do no harm if it stays in much longer). Then open again, neutralize with a saturated solution of common soda, dry and pump in fresh

acid; then enter with the file (XX) and very gently try to find the opening to the remainder of the canal. Continue this same treatment from time to time until you will ultimately succeed in passing the constriction

no matter how long it may be, and arrive at the true foramen. This is

the only type of case (that is, where the construction involves the apical

portion of the canal) in which I intentionally pass through the foramen. 50 Proceedings North Carolina Dental Society

I believe that where there have been such heavy deposits of secondary dentin, that the accessory canals have been reduced to mere tubuli, or totally obliterated. In those cases in which we pass with comparative freedom to the apex, we should discard our files just before we reach the foramen. It is usually an easy matter to tell when we are approaching the foramen, for when the point of the instrument is working in cementum it has an entirely different "feel" than when it is in dentin. With a very little training this difference can be easily detected if the thumb and finger are not calloused—and no dentist should allow the skin on his operating finger and thumb to become thick and hard. Keep it soft and sensitive by rubbing with a cake of pumice or sapolio. If the above method fails you, you can resort to the diagnostic wire and the X-Ray, or penetrate entirely through with the XX fine probe, or pathfinder, then by com- parison with the depth of penetration of your file.you can tell just how far the foramen is from the point of your file. I like for my file to come within 1-16 or 1-32 of an inch of the main foramen. After you have reached this point with the XX fine file, proceed to enlarge to any size you may desire with successively larger sizes of file, but still carefully avoid enlarging the foramen. Of course in many cases the foramen is larger than your smallest file, and in that case you may clean out the foramen but do not enlarge. I find it just as easy to fill a very small canal if the walls are smooth as it is to fill one the size of a pencil lead. Of course during all of this process of opening and enlarging, we have been constantly pumping in acid and neutralizing it for the purpose of removing the filings and other debris. THE STERLIZATION OF THE CANAL

I never under any circumstances open and fill a canal or canals at one sitting. If they are opened in one sitting I then dry out thoroughly and again flood them with 30% acid which is sealed in for at least 24 hours. This is what sterilizes the canals and tubuli. I consider the use of formocresol, phenol, trichloracetic acid, and other such powerful esca- rotics contraindicated. Oil of cloves might be used except for the fact that it is not a germicide. When the patient returns for the filling, I dry out (but do not neutralize) the acid with Johnson & Johnson's absorbent points, and if the case is an infected one, we are now ready for our ionization. Ionization is another of the mysteries of dental treatment. It is used purely empirically. We do not know what it does or how it does it. We do know that it does not sterilize. Numerous technical and scientific, and equally abstruse explanations have been offered but their only accomplishment has been to leave us in even greater confusion. Your essayist, after two years of constant daily use, is of the conviction that ionization does produce some beneficent result. The tentative conclu-

sion that I have arrived at is, simply stated, it causes more or less dis- integration of the tough granulomatous tissue, somewhat akin to cau- terization and inhibits the bacteria present. This produces more ready Proceedings North Carolina Dental Society 51

phagocytosis and autolysis or digestion and absorbtion of both tissue and bacteria. I would not consider my equipment complete without an ionizing apparatus. Now having successfully opened and ionized our pulp canals we are

ready to fill them.

The first requisite is the absolute dehydration of the canals. It is a physical impossibility to successfully fill and seal any canal which has the slightest trace of moisture in it. Dry out well with absorbent points or cotton, pump 95% alcohol to the absolute apex, absorb with points or cotton and then with hot air in chip blower or hot air syringe dry the canals until you are confident that all of the alcohol has been evaporated. In this way you will dry out even the tubuli to a certain extent so that they will simply drink up your chlororesin. With the canal about half full of this solution, insert your dry and sterile guttapercha point and begin pumping it back and forth. Continue until the point is entirely dissolved, or shows no further tendency to dissolve. If during this process the patient has given no indication of pain, place in a small home- made but sterile cone of temporary stopping and pack it in with your canal pluggers. Your packing must be somewhat regulated by the known size of your canal and foramen, for in some cases the patient will not show pain even when you have forced a very great excess through the foramen. When you are in doubt as to having plugged the foramin, do not hesitate to use great force in condersing. I frequently use the auto- matic mallet for this purpose and have after resorted even to the hand mallet. Where these are used, your gold pluggers are the only paints which will answer.

When you have finished the canal filling, unless you intend using pins in the canals for retaining your coronal resotration, the pulp chamber should be immediately filled with oxychloride cement. The radiograph is then taken to prove your work. And by-the-way, set your sights right now to own a radiograph machine. Long before you have retired to the fashionable suburb, or the poor house as the case may be, they will be as necessary as the dental chair. Take the lead—beat the other fellow to it—and then show him how to use it.

I cannot close without a few strong words on sterility, or asepsis.

The rubber dam should always be in position, with a clamp to hold it. The tooth, dam and clarnp should always be painted with iodine. Only instruments which have been boiled or otherwise sterilized (and kept so) should ever enter a canal. Your cotton or points for drying must be sterile and your guttapercha points should be kept continually in 1-500 solution bichloride (use the white tablets to prevent discolotarion) or 60% grain alcohol. Finally, just before inserting your filling give your hands the best scrubbing you know how, using a stiff bristle brush, just as though it were your own tooth you were going to fill. Make capital of these aseptic precautions; let your patient know about them and they will not only appreciate it personally, but will tell others about it. 52 Proceedings North Carolina Dental Society

I will now show a few pictures and after that I will be glad to try to answer any questions any of you may wish to ask. The following clinics were given during the day: Dr. Harry B. Johnson, Atlanta, Ga.—"Amalgam Tech- nique." Dr. R. M. Olive, Fayetteville—"Removable Bridge Work with Cast Clasps." — Dr. J. S. Spurgeon, Hillsboro "Extraction and Curette- ment of Necrotic Areas." — Dr. J. C. Watkins, Winston-Salem "Care and Preserva- tion of Children's Teeth." — Dr. J. H. Wheeler, Greensboro "Radiographs Showing Bone Regeneration after Root Canal Treatment." Dr. Buford Hancock, Atlanta, Ga.—"Conductive Anaes- thesia and Curettage."

. REMOVABLE BRIDGE WORK WITH CAST CLASPS

R. M. Olive, D.D.S., Fayetteville, N. C.

TECHNIQUE

The patient's teeth to be clasped are cleaned and polished, and the occlusion noted and space must be provided for the lugs at this time,

if it does not exist. Next, an accurate plaster impression is taken, and

this is one of the main things in the whole process, because it is impossible to make a perfect bridge without an accurate impression. A small bridge

tray is oiled. The impression plaster should be mixed thinner than for other work, as we wish to obtain sharpness and definition in all out tooth lines. When the plaster is about set, the tray is removed. The plaster is allowed to complete its setting. The plaster is scored at suitable

points so it that can be removed in sections. The sections are then put together in the impression tray and stuck together with a little sticky wax. Several impressions are taken before we secure an accurate one, generally. Next, a modeling compound impression is taken of the op- posing teeth and a small guide bite in wax is taken; then shade of teeth is noted. The patient need not be seen again until the bridge is complete.

The impression is coated lightly with shellac and with sandarac, and is set aside to harden. The teeth to be clasped are made removable from the model, and are packed with amalgam, sinking small dowels into

the amalgam before it begins to harden. Care should be taken to shape and smooth the dowels so they will draw easily from the model, and to set them as parallel as possible, so that both teeth no matter how badly tipped, can be removed in the same plane. After the amalgam has set,

the dowels are oiled, and the balance of the impression is packed with Proceedings North Carolina Dental Society 53

Weinstein's Artificial Stone. The artificial stone gives a more satisfactory working surface than plaster of paris, and is very much harder. The compound impression is also poured, and the two resulting models are mounted on an anatomical crown and bridge articulator, using the wax guide bite to establish occlusal relations. We now have a correctly articulated model with two removable Amalgam teeth, having their dowel pins in the same plane so that both teeth can be removed freely. The clasps are then outlined on the amal-

gam teeth, waxed up and cast. I use Kerr's Graphite Inlay Compound. After freeing the clasps from all adhering investment they are boiled in an acid bath, and smoothed and fitted to the teeth, which, being removable, make this part easier. A Davis bicuspid crown, or an Ash tube tooth of proper shade is ground so as to leave sufficient thickness for a saddle.

The middle section, comprising the saddle, cup for porcelain, and post, is then cast. A post of any high fusing metal, about 15 wire gage B. & S. picked up in the casting, and may be made doubly secure after casting, with a bit of solder. After pickling and cleaning, this middle section is placed in proper relation to the clasps on the model, plaster relations of the parts are taken, and the three parts assembled at one soldering. The framework is then tried on the model and any error in fit resulting from the soldering process corrected, if necessary.

The framework is then polished, and the porcelain teeth are cemented to middle section. In making the lower anterior bridge, demonstrated at my clinic, I usually solder the facings to the clasps.

The casting gold is one of the most important items. Mr. Wein- stein of New York, has evolved a new alloy for casting clasps, now known as Ney-Oro casting gold "E". This casting gold is a combination of several metals, such as platinum, gold, palladium, and a few other metals that are required to make the alloy perfect. This metal resembles a steel spring. It is very rigid and has the quality of a piece of well tem- pered steel. The base for the saddle is cast of Ney-Oro casting gold "E".

These casting metals may be had from J. M. Ney Company. Do not use any substitutes or your bridge may be a failure. The clasps must have the properties mentioned above. ADVANTAGES CLAIMED FOR THIS TYPE OF BRIDGE

1. An appliance that can easily be removed and cleaned by the patient. 2. No grinding of enamel, except a small place for the lugs, and no devitalization of pulp. 3. Can be constructed with a minimum of nervous strain to the patient and dentist. 4. Has a maximum of stability and food grinding surfaces. 5. There is nothing to irritate the gums. We would not think about putting a removable bridge of this type in for a person who does not brush his teeth regularly and carefully. There will be no decay where the teeth are kept clean. If a cavity should 54 Proceedings North Carolina Dental Society

result from the clasp it can be easily repaired with the many methods we have at our disposal. The following telegram was read to the Society: Ft. McPherson, Ga., June 21, 1918.

Dr. J. Martin Fleming, N. C. State Dental Society.

The noble generosity of the Society has sent a thrill of pride in the Old North State through Base Hospital Sixty-five. We shall strive to be worthy of your trust. Capt. H. O. Lineberger Capt. Geo. K. Patterson The Society adjourned:

EVENING SESSION, JUNE 21.

The Society was called to order at 8:50 P. M., with Dr. S. R. Horton, of Raleigh, presiding. The Executive Committee presented the application for membership of Dr. L. E. McKeown, Stanley, N. C, who was duly elected after an adjournment of one minute. Dr. Squires then took the chair. Dr. Squires: Dr. Hunt would like just a few minutes to present the work of the Preparedness League, and I hope that if there are any here that are not members of this league, that they will at least consider the work and the sacrifice that Dr. Hunt has done for this league. He has hired a stenographer at his own expense for over a month, paid all the postage out of his own pocket and paid all of his expenses. Mr. President and Members of the North Carolina Dental Society:

I am not down on the program to give this talk on the work of the Preparedness League of American Dentists, however, the Executive Committee has kindly consented to give me these few minutes, and I am anxious to avail myself of this opportunity. As many of you know, this work originated with Dr. Beach in Buffalo, N. Y., sometime before we entered into the war. Dr. Beach has worked in season and out of season, in his effort to make our soldiers dentally fit, with the object in view of making an efficient fighting machine of our soldiers. A great deal of work has been done by Dr. Chas. Ashe, of New York. Dr. Ashe has contributed a great deal of his time and money to do this work, he being the Director General.

Dr. T. P. Hinman is District Director and he gives freely of his time and effort to the work. Lieut. Heckard, now Major Heckard, has worked diligently to get Proceedings North Carolina Dental Society 55

this work started throughout the United States with the one object in view—to defeat the Hun in the least possible time. A large number of the men in hospitals in France are there because of dental defects. As taxpayers, every dentist should consider this work as an economic saving,

because it certainly costs money to keep a soldier in the hospital and the war is prolonged proportionally that much longer.

I have been asked about the one dollar membership fee. While no official is paid a cent, the clerical force, office rent, record card, printing

and stationery, cost money. Your dollar is needed and I hope every dentist in North Carolina will send his dollar and become a member.

As Director for North Carolina, I have met with quite a good deal of discouragement, mostly through lack of understanding as to the method and object of the work.

I am sorry Dr. Squires mentioned the insignificant amount of time

and money I am giving to this work, as I consider that we are all trying to do our part.

I have been asked by some dentists if they are "sure enough expected to do the work and furnish the materials free." All the work is absolutely free and voluntary. What is this little effort on our part as compared with the sacrifice of the men who have given up good practices and have already gone into the army? What is our sacrifice as compared with that made by Dr. Patterson and Dr. Lineberger and others?

"Why can't the army dentists do this work," I have been asked. (Pictures of army dental equipment were shown here). A camp stool and a portable chair does not make the best equipped office, and you can readily see the handicap of the boys in the army. Of course there are several Dental Ambulances as here shown (pictures of Dental Ambu- lances shown), but not enough to meet the requirement. The training camps and hospitals are being equipped with modern dental outfits as here shown. (Pictures of Dental Infirmaries shown). In time the army will be pretty well prepared to take care of its own dentistry. (Record cards properly filled out where ere shown). There seems to be a lack of knowledge concerning the manner of filling out the cards and the slides are intended to more clearly explain the method.

Form 3-D is the new card. (See Illustration No. 1.) 56 Proceedings North Carolina Dental Society

O Am CO

K U t-«

I- 0) O a. < PQ H U u p z < Proceedings North Carolina Dental Society 57

should do the work. The registrant takes this card and delivers it to the dentist who does the work. After the work is finished, the dentist who did the work simply draws a line through the name and address on the address side of the card, and the postmaster will deliver the card to 50 East 42nd St., New York, where all records are kept.

< IL

z z a a O 111 Q < c m z D -I LJ z U .3 >- LU \- o 1^ bJ I \- U c (A < < I- I- UJ I U) ^- (0 J I- O UJ < < z QL Q - Q z X ^ O Q UJ >- < a: Q m < u u III 111 < o: U u. a: !0z IL K UI UJ h Z > > 01 H < i a. I UJ \ii a O z

Ul r >- tt K ^ I- 2 u z < o Q

I JLUVd 58 Proceedings North Carolina Dental Society

Illustration number two shows the record side of the card where "Part one" contains the name and address of the registrant that is to report at the office of the chairman of the Local Unit at a definite date when the chairman, after examination, will fill in "Part two", thus as- signing the registrant to the dentist who is to do the work. The dentist doing the work will simply follow instructions on the card. A very good plan suggested, is for the chairman of the Local Unit to fill in dates at which he wishes, say twenty, or any other number of men that he desires at one time, to be sent to his office, and another twenty or so for another definite date, and so on throughout the work. The chairman can secure the names of all class "A" registrants and simply fill in number one and the name and address of the registrant and mail directly to the registrant. This plan will obviate any work on the part of the Exemption Board.

I have tried to appoint young men as chairmen of Local Units and they often write me that the Exemption Board had not sent a single man to them. The Exemption Boards have been instructed by the Adju- tant-General's office to cooperate with the chairman of the Preparedness League in this work. I refer you to serial No. 217-A which is as follows: STATE OF NORTH CAROLINA Governor's Office RALEIGH

Series No. 217-A March 9th, 1918 Free Dent.\l Service for Selective Draft Men Under Direction OF THE Preparedness league of American Dentists To All Local and District Boards: The preparedness League of American Dentists, is offering free dental service for all registrants selected for service in order that these men may be dentally fit before they are sent to camp. Directors have been appointed for most of the counties who will see that the service is rendered. The Local Boards are requested to send the registrants to the respective directors named in the list hereinafter given, where they will receive full instruction and be assigned to the particular dentist who will do the dental work for them. John D. Langston, Major Inf., U. S. R. Special Aide to the Governor.

You may refer to that serial in discussing the question with your Exemption Board. However, tact may be necessary, but you should have no trouble. Some Exemption Boards have written the Adjutant- General that they have sent men to the Preparedness League only to be turned down. For the most part, there is full cooperation between the Exemption Boards and the League. Up until May 1st, North Carolina had reported only 668 operations, just about one operation per dentist. An adjoining state had reported seven operations. Gentlemen, we have done more than 668 operations, Proceedings North Carolina Dental Society 59

but we have failed to record them. Hereafter, record every operation and send the record card Form 3-C or the new Form 3-D to 50 East 42nd St., New York, as directed on the card. Also don't fail to record the summary on form 18 and when that card is filled in, send to 508 Legal Bldg., Asheville, N. C. Let's be proud of North Carolina's record when the Hun is whipped. In the manner in which this work has been done, several Units stand out prominently among which might be mentioned Pasquotank Unit. Dr. Powell has done splendid work at Ahoskie. Dr. Keith at Hender-

sonville is perhaps the star Unit chairman. I am proud of the work

he has done. He has worked out a splendid plan, and I hope you will give him an opportunity to explain to you just how he keeps ahead of the Exemption Board. I thank you for this opportunity to explain something of the work of the Preparedness League.

Dr. Keith: Mr. President and Gentlemen of the North

Carolina Dental Society. I feel very much gratified that Dr. Hunt has just said what he has about the work that we are doing in Henderson County.

When Dr. Hunt first wrote me, I immediately went to see the local board and found out that our physician who was making his examination had already begun his work,

and I found that we had to resort to some other means to

get these men back. I went before the local board, and we had some cards printed, following a plan devised by me and some other dentists. We had these cards, fifty in number, and had the men come in a certain day, and instead of giving

an hour a day, we decided to give an afternoon because it would help some of the men coming from a distance. There was one man who could not give this time in this way, but he took his cards and gave an hour a day. I found I could do more work spending one afternoon. There were several who gave a day's time. We called in 150 men and examined a few over a hundred, 105 maybe, and there are others who did not take advantage of having the work done. We found only two men who did not need immediate attention.

I was talking to Lieut. Hurdle from Fort Caswell here today, and he is the only dentist there and has two thousand to three thousand men. You can see that the time has come when it is up to us to do ,not our bit, but to do our best for the men who are going to fight our battles. 60 Proceedings North Carolina Dental Society

Dr. Everitt: I have heard Dr. Hunt and Dr. Keith, and I want to say that the Raleigh dentists have done their part, but I am satisfied that there are others who have done what I have done and not sent in any report.

Dr. McConnell: I would like to ask Dr. Hunt a few questions about that. We began this work for the soldiers before we joined the Preparedness League. When our National Guard was first called for service on the border, we went before them and tendered them our services to do such work as would be done for them in the army free of charge. I regret to say that the young men did not appreciate that a great deal. Out of the four hundred men in the two organizations, perhaps only forty availed themselves of that proposition. Later we joined the Preparedness League and like Dr. Everitt we have not made any reports on it.

Gaston County I think has about two thousand or more men in class one. We did not feel that the three dentists in Gaston County could do the best service for those men by trying to take them serially and do the work for them. It was too large a job; so we simply told the physician of the exemption board that there would not be a man turned down from Gaston County who could be made dentally fit for that work. When he finds one that would not be dentally fit, we take him in hand. I understand Dr. Hunt referred only to the army. I take it that it includes the navy also.

Dr. Hunt: I think it does.

Dr. McConnell: Along that line I have another question

I want to ask. A young man tried to get into the na\^ and they turned him down on account of his teeth. He came to me and told me he wanted to go. I suppose he came to me about six or eight times. He came back to me after he got in and he said, "You offered to do this for me without charge, but I am plenty able to pay for this work," and he paid me.

Now should I report this on that card?

Dr. Hunt: No, I think not. Dr. McConnell: In the matter of handling them, we have about forty thousand people in our county and only three dentists and two thousand drafted men.

Dr. Hunt: I belive some of the people of Gaston County Proceedings North Carolina Dental Society 61 are going elsewhere for their dental work, and the dentists of the adjoining county should help out on that. The idea is to get these men who are actually going into the trenches so that they will not have to go to the hospital to make an efficient fighting machine to give the Kaiser the fifty-seven varieties of hell.

Dr. McConnell: Our efTorts were to get men in Class 1. If you could fix up five Class 1 men you were doing the same amount of good as if you were fixing up five men so that they would be in Class 1. You have got to use your discretion to do the greatest amount of good that you possibly can, often at your loss. You can do the greater amount of good for ten men doing necessary things, than taking the same amount of time in doing bridge work for one man. Don't go to doing a lot of expensive work for nothing. TREASURER'S REPORT RECEIPTS

Balance on hand last report $1,272.75 Received for dues 812.00 Received for membership _ 335.00 Received for Exhibit space at Durham 235.80

$2,655.55 DISBURSEMENTS

Paid on expenses at Durham $ 295.75 Paid National Dental Society 428.00 Paid Membership fee returned 5.00 Paid Expenses for proceedings 185.09 Paid Secretary Salary and expenses for last year 110.75. Paid Treasurer's Bond 5.00 Paid Dues returned 8.00 Paid Treasurer's Salary and Expenses 54.50 Paid Secretary's Salary and Expenses.- 101.52 Paid expenses at Wrightsville 333.84

Total $1,527.45 Balance on hand $1,128.10

$2,655.55 $2,655.55 Respectfully submitted, R. M. Morrow, Treasurer. June 21, 1918. On motion this report was adopted. 62 Proceedings North Carolina Dental Society

REPORT OF AUDITING COMMITTEE.

Wrightsville Beach, N. C, June 21, 1918 We, the Auditing Committee of the North Carolina Dental Society, have examined the books of the Treasurer and find them correct to date. Whitfield Cobb, Chairman, For the Auditing Committee.

(In the absence of the other members of the Auditing Committee, Dr. Martin assisted the Chairman in auditing the books of the Treasurer.) On motion this report was adopted.

Dr. Judd: If it is not out of order, I would like to make a motion that we invest a part of that balance in the treasury in War Savings Stamps or Liberty Bonds, say $500, at least. Dr. Everitt offered an amendment making the amount $200, and motion as amended carried.

Upon motion of Dr. J. Martin Fleming, the Society authorized the payment of five dollars to the watchman in addition to amount to be paid through Dr. Stanley. REPORT OF LEGISLATIVE COMMITTEE.

Dr. Tucker writes: There is no report, especially necessary from the Legislative Committee. There has been no session of the Legislature since last meeting. This report was adopted. REPORT OF COMMITTEE ON ETHICS.

Dr. Warren: Nothing to report. REPORT OF COMMITTEE ON ORAL HYGIENE

Dr. J. C. Watkins: For the last five or six years your committee has been reporting that they have been con- ferring with the school superintendents and with the State Board of Health, and at this time we wish to state that the address by Dr. Cooper of the State Board of Health be adopted as our report. Report was adopted as stated. REPORT OF EXECUTIVE COMMITTEE

The Executive Committee wishes to thank the visiting Dentists, Drs. Stevenson, Simpson, Johnson and Hancock, for their services in making a success of the clinics. Also the local clinicians who have done their part towards making the meeting a success. The thanks of the Society is also extended to the local Dentists of Wilmington for their Proceedings North Carolina Dental Society 63

help and cooperation and the use of their offices for the cHnics of the students standing examination. Also we wish to thank the Tidewater Power and Light Company for courtesies shown us. And especially do we appreciate the treatment we have received from the manager of the Oceanic Hotel, Mr. Hooper. He has been untiring in our interests and

we appreciate it. We also wish to thank the Exhibitors for the displays made in these strenuous war times. We feel that the meeting has been a success in every way through the hearty cooperation of the full membership and we wish to commend that spirit of cooperation and ask that

it be continued for next year and the years to come.

J. S. Spurgeon, Chairman. This report was adopted. REPORT OF COMMITTEE ON PRESIDENT'S ADDRESS.

Our president in his usual careful and painstaking manner, has given us one of the best addresses in the history of our society. The address should be thoughtfully considered as his recommendations are of vital importance, and their adoption means substantial advancement in the progress of the profession. We recommend:

1st. That before an election, where there is more than one candidate for an office, the Treasurer read the names of those entitled to vote.

2nd. We approve of his recommendation in regard to revising our By-Laws, etc., and recommend its adoption.

3rd. We heartily endorse the suggestion in regards the further advanced step and recommend that we have a one week's Post Graduate Course at our next meeting, similar to the one recently held in Oklahoma, and that onr Executive Committee work out the details and arrange for same.

4th. For several years we have desired the cooperation of the Medical profession in regard to the instruction and care of the teeth of the school children of North Carolina. We are gratified that the State Board of Health, through Dr. Cooper, has come and asked our cooperation along this very line. We recommend that this Society endorse and cooperate in this movement in every way possible.

5th. That we give our hearty support and cooperation to the insti- tution training and preparing the Dental Nurses, and that we request our Legislative Committee use its discretion in regard to asking for legislation at the next session of the Legislature, that will properly recognize and license the Dental Hygienist. Respectfully submitted,

J. C. Watkins J. S. Spurgeon Rosebud Morse 64 Proceedings North Carolina Dental Society

Dr. Spurgeon: I would like to say one word on that report, especially in regard to the proposition of making our next meeting a week post-graduate course. We wanted to recommend that, but still we don't want to do that unless

it is the opinion of those present that it should be done. We would be glad to have a vote or an expression on it.

Dr. p. E. Horton: I take it that there are so many things to consider in regard to the expense, etc., that it would be hard to say whether we should go into it. I believe this body here ought to vote that if it is the opinion of the Execu- tive Committee that we should then go into it.

Dr. Everitt: I am most heartily in favor of that proposition, but "these be perilous times" as the old negro said. We do not know where we will be, whether in Germany or in the United States. I think we had better go very slow.

If we adopt that, I think it should be adopted with this idea: Let the Executive Committee decide whether we have one week's work or three days' work as we now have. We don't know what may be the conditions. President Squires: May I say that that was what I really had in mind.

Dr. Everitt: I make this motion that the report be adopted as handed in by the Executive Committee and that that be left with the Executive Committee.

Dr. Spurgeon: I have heard this of the Oklahoma plan.

As I understand it, the Oklahoma State Dental Society was practically defunct; they had lost interest; when two or three live men took hold of it and started this post graduate course, taxing each gentleman who came to it $25 for the post-graduate course. The first year they had enough to pay their clinicians, and it seems a large number of men in Oklahoma are very much interested in it. If we had one hundred men attending this meeting, probably a ten dollar fee would cover this expense. If we had fifty men it might take twenty dollars. Of course the details of this meeting would have to be worked out.

Dr. p. E. Horton: If the whole of the Society took an

interest in these things, I think it would not be necessary

to tax each man over $5.00; but if the whole Society doeg Proceedings North Carolina Dental Society 65 not approve of the plan, we cannot tax the members of the Society for the benefit of a few. Dr. Watkins: Someone informed me that the cost of this Oklahoma post-graduate course was about a thousand dollars, and I think that if the Executive Committee thought that it was not practicable we would not have it.

Dr. J. Martin Fleming": We must not forget that we will only have about three hundred dollars in the treasury about the first of September and if we plan this clinic we must look to the individuals who take this course to pay the money. But it is hardly fair to have this course only for men who are paying $10 apiece, to take funds out of the

Society treasury to help pay for it.

Dr. Levy: I would suggest that we adopt this motion with the understanding that we leave it to the Executive Committee and that they send out cards to each member and find out how much that they are willing to pay, five, ten, fifteen dollars. Dr. Everitt: Suppose we send out those cards and one hundred men say that they would be responsible for five or ten dollars for the special course. Here are one hundred other men who do not feel like paying that five or ten dollars, and we are excluding those men. We have no right to exclude them. They would have a right to withdraw; and not only that, when they are excluded that would be bringing class legislation, and we want to go slow on that. The question was called for and the motion carried, the motion as restated by Dr. Everitt being, that the question of holding a week's meeting to be referred to the Executive Committee to be acted upon by the Executive Committee at some future date prior to sending out the announcements of the meeting. The Treasurer then announced the names of those suspended for non-payment of dues. Motion duly carried that the name of Dr. John G. Bell be retained on the roll. 66 Proceedings North Carolina Dental Society

ELECTION OF OFFICERS.

President J- N. Johnson, Goldsboro First Vice-President R. T. Gallagher, Washington Second Vice-President A. S. Cromartie, Fayetteville Secretary W. T. Martin, Benson

Treasurer R. M . Morrow, Burlington Eassayist D. E. McConnell, Gastonia

.• • *• ( F. L. Hunt, Asheville DelegatesT-. 1 ^ to. NationalXT 1 AssociationA -J R. M. Morrow, Burlington

Merribers of Examining Board elected at ( F. L. Hunt, Asheville

this time Ii J.-J. Martin Fleming, Raleigh

Asheville was chosen as the next place of meeting. After the installation of officers in the order of their election, the President appointed the following committees:

Comtnittees executive

R. M. Squires, Chairman, Wake Forest, N. C.

J. Martin Fleming, Raleigh, N. C. P. R. Falls, Gastonia, N. C. ethics

J. R. Edmundson, Chairman, Wilson, N. C. E. R. Warren, Goldsboro, N. C. I. H. Davis, Oxford, N. C. legislative F. L. Hunt, Chairman, Asheville, N. C.

J. Martin Fleming, Raleigh, N. C. E. J. Tucker, Roxboro, N. C. auditing

Whitfield Cobb, Chairman, Winston-Salem, N. C.

Sam Levy, Charlotte, N. C. J. A. Yarborough, Wake Forest, N. C. oral hygiene

J. C. Watkins, Chairman, Winston-Salem, N. C. T. P. Bxn.LARD,^Roseboro, N. C. Oscar Hooks, Wilson, N. C. exhibits

Joseph Fulton, Chairman, Asheville, N. C.

R. A. Little, Asheville, N. C. J. W. Faucette, Asheville, N. C. PROGRAM

H. L. Keith, Chairman, Hendersonville, N. C, J. S. Spurgeon, Hillsboro, N. C. W. F. Bell, Asheville, N. C. There being no further business, the Society adjourned SINE DIE. Proceedings North Carolina Dental Society 67

PRESIDENTS OF THE SOCIETY SINCE ITS ORGANIZATION.

1875-6 *B. F. Arrington

1876-7._ - ..*V. E. Turner

1877-8 *J. W. Hunter

1878-9 - *E. L. Hunter 1879-80 D. E. Everitt 1880-1 *Isaiah Simpson

1811-2 - M. A. Bland 1882-3- -.-*J. F. Griffith 1883-4 *W. H. Hoffman

1884-5 - J. H. Durham

1885-6. - J. E. Matthews 1886-7. B. H. Douglas 1887-8 *T. M. Hunter

188-9 - *V. E. Turner 1889-90..._ S. P. Hilliard

1890-1 - H. C. Herring 1891-2 C. L. Alexander

'.. 1892-3._ - F. S. Harris 1893-4 *C. A. Rominger 1894-5 - H. D. Harper

1895-6 - R. H. Jones

1896-7 J. E. Wyche

1897-8 - H. V. Horton 1898-9 C. W. Banner 1899-1900 A. C. Liverman

1900-1 - -E.J. Tucker

1901-2 _ J. S. Spurgeon

1902-3._ - J. H. Benton

1903-4.._ J. M. Fleming 1904-5 W. B. Ramsay

1905-6 J. S. Betts

1906-7 J. R.Osborne 1907-8 D*. L.James 1908-9 F. L. Hunt

1909-10 J. C. Watkins 1910-11...... A. H. Fleming 1911-12.__ P. E. Horton 1912-13 R. G. Sherrill 1913-14 C. F. Smithson 1914-15 J.A.Sinclair 1915-16 1. H. Davis 1916-17.— R.O.Apple 1917-18 _ R. M. Squires

1918-19- J. M.Johnson

*Died. 68 Proceedings North Carolina Dental Society

SUCCESSFUL APPLICANTS FOR LICENSE BEFORE STATE BOARD OF EXAMINERS. January, 1918.

Irvin, Lafayette Lee.„ 706 W. First St., Marion, Ind Savage, W. F Camp Forge, Va. Scruggs, Jospeh Cuthbert Fulton, Ky. June, 1918. Bagley, Wm. A Blackstone, Va, Bennett, Chas. C Brevard, N. C. Brown, W. James Greenville, N. C. Bryan, Chas. H Apex, N. C.

Campbell, J. F Hickory, N. C. Choate, N. C Sparta, N. C. Cobb, Adoniram J Windsor, N. C. Cox, Ella B Palmerville, N. C. Culler, Oscar E Rock Creek, N. C Current, Wm. Clyde.— Statesville, N. C.

Dupree, J. L. Angier, N. C. Edwards, Alfred C Lawndale, N. C. Harmon, Emmett E Statesville, N. C. Holliday, G. W Wake Forest, N. C. Hunter, Earle W Goldsboro, N. C. Jenkins, Chas. E Palmerville, N. C. Johnson, Floyd G. Hamptonville, N. C. Jones, Edgar, D Statesville, N. C. Keel, Harry L Farmville, N. C. Lewis, Brownie Lee Roseboro, N. C. Liles, Walter Neuse, N. C. Massey, Luthur M Wakefield, N. C. McAlister, Henry A. (Colored) Fayetteville, N. C. Medford, Nick M. Waynesville, N. C. Mercer, Wm. Cassie Fountain, N. C. Moore, Wm. T. Farmville, N. C. Morse, Italy M East Bend, N. C. Murray, Henry V Rock Creek, N. C. Newton, Alex Casar, N. C. Nicholson, John H Harmony, N. C. Perkinson, Robt. H Rocky Mount, N. C. Poindexter, Chas. E East Bend, N. C.

Pool, J. Garve3..._ Raleigh, N. C. Pridgen, D. LeRoy Dunn, N. C. Seay, Arthur L. Shores, Va. Thomasson, B. C Bryson City, N. C.

Turner, J. V Oxford, N. C, Weatherman, W. C - Statesville, N. C.

West, J. Frank Weldon, N. C. Yount, Chas. B Hickory, N. C, Proceedings North Carolina Dental Society 69

ROLL OF LIFE MEMBERS, BY VIRTUE OF HAVING PAID DUES FOR TWENTY-FIVE CONSECUTIVE YEARS.

Alexander, C. L Charlotte N. C.

Battle, J. J - Rocky Mount N. C. Carr, I. N Durham N. C. Carroll, N. G Raleigh N. C. Conrad, W. J Winston-Salem N. C. Everitt, D. E Raleigh N. C. Hilliard, S. P Rocky Mount N. C. Horton, H. V Winston-Salem N. C. Jones, R. H Winston-Salem N. C.

Little, J. B Newton N. C. Liverman, A. C Scotland Neck N. C. Lynch, William._ Durham N. C.

Mathews, J. E Wilmington N. C. Morrow, R. M Burlington N. C.

Parker, J. M ..Asheville N. C. Patterson, G. B Fayetteville N. C. Ramsey, R. L... Salisbury N. C. Ross, T. T Nashville N. C.

Spurgeon, J. S Hillsboro N. C. White, L Statesville N. C. Whitsett, G. W Greensboro N. C. W^yche, J. E Greensboro N. C. HONORARY MEMBERS.

Adair, R. B Atlanta, Ga.

Adair, Robin _ Atlanta, Ga. Banner, C. W Greensboro, N. C. Beadles, E. P.._ Norfolk, Va.

Bland, M. A.._ _ Charlotte, N. C. Bland, C. A Charlotte, N. C. Bogle, R. B Nashville, Tenn.

Bryan, N. L _ Newton Grove, N. C. Byrnes, R. R Richmond, Va.

Callahan, P. E.._ _ McRae, Ga. Campbell, H. W..__ Suffolk, Va. Carroll, Delia Dixon... Raleigh, N. C. Chisholm, W. W Anderson, S. C. Collins, Clara C ..Atlanta, Ga. Cooper, George M. (M. D.) ...Raleigh, N. C. Cowarden, L. M— Richmond, Va. Crenshaw, Wm Atlanta, Ga. Cryer, M. H Philadelphia, Pa. Cuthbertson, C. W Washington, D. C. Dale, J. A Nashville, Tenn. 70 Proceedings North Carolina Dental Society

Eby, Jos. D _ Atlanta, Ga. Foster, S, W _ Atlanta, Ga.

Goldberg, E. H Bennettsville, S. C.

Gorman, J. A New Orleans, La, Harrison, G. R Richmond, Va. Heatwole, T. O Baltimore, Md.

Hill, Thos. J. Cleveland, Ohio Hinman, Thos. P Atlanta, Ga. Hoffman, W. H Amber, Pa. Holland, Frank Atlanta, Ga. Howard, Clinton, C Atlanta, Ga. Huff, M. H Atlanta, Ga. Hughes, C. N Atlanta, Ga. Johnson, H. H Macon, Ga. Kelsey, H. L Baltimore, Md. Kirk, E. C Philadelphia, Pa. Lambright, W. E Atlanta, Ga. McCulloch, F. R Atlanta, Ga. McGuire, Daisy Sylvia, N. C. Moore, S. W Baltimore, Md. Morgan, H. W Nashville, Tenn. Nodine, Alonza M.._ New York, N. Y. Quattlebaum, E. G Columbia, S. C.

Ruhl, J. P New York, N. Y. Rutledge, B.._ Florence, S. C. Silverman, S. L— Atlanta, Ga. Simpson, R. L Richmond, Va. Sherrill, R. G Fort Bayard, New Mexico Smith, B. Holly Baltimore, Md.

Smith, A. E Chicago, 111. Spratley, W. W Richmond, Va. Starr, E. L „ Philadelphia, Pa. Stevenson, Albert H...._ 576 5th Ave., New York, N. Y. Stewart, H. T New York, N. Y. Stone, A. E Philadelphia, Pa. Strickland, A. C Anderson, S. C. Teague, B. H Aiken, S. C. Thompson, Webb South Carolina Tileston, H. B Louisville, Ky. Turner, C. R Philadelphia, Pa. Turner, M. E Atlanta, Ga. Visanska, S. A Atlanta, Ga.

Whitaker, J. D Indianapolis, Ind. White, J. A Williamston, N. C. Whitehead, C. A _ „ Scotland Neck, N. C. Wooding, C. E Winston-Salem, N. C. Proceedings North Carolina Dental Society 71

ROLL OF ACTIVE MEMBERS.

Adams, A. J Durham, N. C. Alexander, C. L Charlotte, N. C. Allen, R. T Lumberton, N. C. Allen, T. I Waynesville, N. C. Andrers, F. R Charlotte, N. C. Apple, R. O Winston-Salem, N. C. Apple, T. A „ Winston-Salem, N. C. Ashburn, T. F Liberty, N. C. Aycock, B. L Princeton, N. C. Bain, C. D...._ Dunn, N. C. Baird, C. D Franklin, N. C. Baker, L. P Kings Mountain, N. C. Ballon, N. T Richmond, Va. Banks, C. H Louisburg, N. C.

Banner, J. E, Mt. Airy, N. C. Barber, A. D Sanford, N. C. Barker, O. C Asheville, N. C. Barnes, V. M Wilson, N. C. Battle, J. J Rocky Mount, N. C. Bell, John G Morehead City, N. C. Bell, W. F Asheville, N. C. Bender, O. J Pollocksville, N. C. Benbow, Arthur D Sanford, N. C. Benbow, L. M Winston-Salem, N. C.

Betts, J. S Greensboro, N. C. Bingham, L. R Denton, N. C. Bivens, S. B Marshville, N. C. Blanchard, Dexter..„ Fuquay Springs, N. C. Bone, A. C Rocky Mount, N. C. Branch, E. A.._ Norwood, N. C,

Brooks, J. H Burlington, N. C. Bryan, Chas. H Apex, N. C. Bullard, T. P Roseboro, N. C.

Butler, J. R..__ Dunn, N. C. Butler, S. E.. — Warsaw, N. C. Caldwell, D. S Charlotte, N. C.

Carlton, J. D Salisbury, N. C. Carlton, J. W Spencer, N. C. Carr, Geo. A Durham, N. C. Carr, H. C Durham, N. C. Carr, L N Durham, N. C. Carroll, N. G Raleigh, N. C. Carson, H. H Hendersonville, N. C. Casstevens, H. E Winston-Salem, N. C. Chamberlain, C. H Yadkinville, N. C. Chamberlain, E. H Rockingham, N. C. 72 Proceedings North Carolina Dental Society

Chambers, E. O Asheville N. C. Choate, E. C Sparta N. C. Clark, M. H. P Wilmington N. C. Clayton, W. F.._ High Point N. C. CHck, E. G Elkin N. C. CHne, C. P _„ Raleigh N. C. Cobb, Whitfield— Winston-Salem N. C. Coble, L. G Greensboro N. C. Cole, R. S Rockingham N. C. Coleman, F. H.._ Ash N. C.

Coltrane, J. F Zebulon N. C. Cone, P. B Williamston N. C. Conrad, W. J Winston-Salem N. C. Cox, Ella B Palmerville N. C. Critz, W. H.._ Albemarle N. C. Craver, A. W Boonville N. C. Crews, R. W Thomasville N. C. Cromartie, A. S Fayetteville N. C.

Croom, J. D Maxton N. C. Culler, O. E Rock Creek N. C. Current, W. Clyde Statesville N. C. Damerson, L. L New Bern N. C. Daniel, H. C.— Salisbury N. C. Daniels, L. M..„ Oriental N. C. Darden, P. I Mt. Olive N. C. Davis, I. H Oxford N. C.

Davis, J. V Concord N. C. Dawkins, C. B Hoffman N. C.

Dreher, J. H Wilmington N. C.

Dupree, L. Justice .-. Angier N. C. Edge, C. E Rocky Mount N. C.

Edmundson, J. R..„ Wilson N. C. Edwards, A. C.._ Lawndale N. C. Edwards, E. L Morganton N. C. Edwards, J. R.— Fuquay Springs N. C. Edwards, L. M _ Durham N. C. Ehrenghaus, E Hendersonville N. C.

Ellerbee, J. H Rockingham N. C. Ellington, R. H ..Salisbury N. C. Evans, E. J Asheville N. C. Evans, Geo. J Asheville N. C. Everitt, D. E— Raleigh N. C. Falls, P. R Gastonia N. C. Farrell, R. M Pittsboro N. C.

Faucette, J. W _ Asheville N. C. Feagin, G. M Albemarle N. C. Fields, Paisley._ Roanoke Rapids N. C. Finch, S. J Zebulon N. C. Proceedings North Carolina Dental Society 73

Fisher W. R Concord N. C. Fitzgerald, Paul._ Greenville N. C. Fitzgerald, W. C Albemarle N. C. Fleming, A. H.._ Louisburg N. C.

Fleming, J. Martin Raleigh N. C. Foster, H. K Greensboro N. C. Frink, B. L Blandeboro N. C. Fulton, Joseph Asheville N. C. Gallagher, R. T Washington N. C.

Gardner, J. M Gibson N. C. Geddie, C. H Winston-Salem N. C.

Gettys, J. H Forest City N. C. Gibbs, W. D Carthage N. C. Gibson, H. B Red Springs N. C.

Gibson, J. L Laurinburg N. C. Glenn, C. F Asheville N. C. Gobbel, W. G Spencer N. C. Gorham, L. M Rocky Mount N. C. Graham, R. F Rowland N. C.

Gregg, J. D Liberty N. C. Gregory, S. W Elizabeth City N. C. Griffin, E. J Edenton N. C. Hair, L. G Fayetteville N. C. Hall, B. F Asheville N. C. Hall, C. B Goldsboro N. C. Hamilton, E. S Marshville N. C. Hamilton, R. F. J Norfolk, Va Hamlin, J. J High Point N. C. Hand, W. L...._ New Bern N. C. Hargrove, T. A Wilmington N. C.

Harrison, E. E. Jr., Olin N. C. Hartsell, W. K Greensboro N. C. Hasty, Vance Statesville N. C. Haynes, F. K ...Chapel Hill N. C. Henderson, H. C Charlotte N. C. Henderson, L. V .....Henderson N. C. Herring, G. F ..Mt. Olive N. C. High, D. P Wilmington N. C. Hilliard, S. P Rocky Mount N. C. Hoffman, M. E.._ Asheville N. C.

Holland, J. M Statesville N. C. Holland, N. T Smithfield N. C. Hollingsworth, W. M Mt. Airy N. C. Holmes, A. G., Jr Southport N. C.

Hooks, Oscar .*. ...Wilson N. C. Hooper, Lyman J Tuckaseigee N. C. Horton, H. V Winston-Salem N. C. Horton, P. E Winston-Salem N. C. 74 Proceedings North Carolina Dental Society

Horton, S. R Raleigh, N. C. Houston, W. C Concord, N. C. Howie, E. B.._ Raleigh, N. C. Hull, P. C Charlotte, N. C. Humphrey, L. M Greensboro, N. C. Hunt, F. L Asheville, N. C. Hunt, Jas. K Jonesboro, N. C. Hunter, E. W Goldsboro, N. C. Milton, Hurdle, J. A N. C. Mebane, Hurdle, J. H N. C. Hutchins, W. Y Marshall, N. C. Hutchison, C. R Walnut Cove, N. C. Wendell, N. C. Ihrie, J. H Jackson, Wilbert ..Clinton, N. C. Dunn, C. Jernigan, J. A N. Jeter, I. P Morganton, N. C.

Johnson, Fred G - Hamptonville, N. C. Goldsboro, N. C. Johnson, J. N Johnson, L. J Middlesex, N. C. Johnson, W. B Selma, N. C. Jones, P. E Farmville, N. C. Jones, R. H Winston-Salem, N. C. Jones, B. P.._ Blackstone, Va. Jones, W. F North Wilkesboro, N. C. Joyner, O. L Kernersville, N. C. „.Fayetteville, N. C. Judd, J. H Keel, D. F Scotland Neck, N. C. Keel, H. L Farmville, N. C. Keiger, C. C.._ Charlotte, N. C. Keith, H. L Hendersonville, N. C. King, D. D Lumberton, N. C. Lane, W. A ..Goldston, N. C. Lawrence, R. U Statesville, N. C. Lazenby, G. A Statesville, N. C. Lennon, C. H Rowland, N. C. Levy, Sam Charlotte, N. C, Lineberger, H. 0...._ Raleigh, N, C. Lloyd, G. Haynesville, N. C.

Liner, W. H : Waynesville, N. C. Lipscomb, C. T Greensboro, N. C. Little, R. A Asheville, N. C. Liverman, A. C Scotland Neck, N. C. Lockhart, D. K Durham, N. C. C. Long, W. S , ..Graham, N. Lynch, Wm Chapel Hili, N. C. McCall, S. H Troy, N. C. C. McClung, J. A Winston-Salem, N. McConnell, D. E Gastonia, N. C. Proceedings North Carolina Dental Society 75

McCracken, F. W Sanford N. C.

McCracken, J. T Durham N. C. McDowell, C. H Waynesville N. C. McGuire, W. P Sylvia N. C. Mclver, D. C Oxford N. C. McKeown, L. E Stanley N. C.

McKinney, J. Y Raleigh N. C. McMillan, E. A Hendersonville N. C. McMillan, M. T.._ Goldsboro N. C. McRae, W. L Elrod N. C. Maddux, N. P Asheville N. C. Malone, S. E Goldsboro N. C.

Mann, I. M.._ Asheville N. C. Mann, L. H Washington N. C. Manning, M. P Robersonville N. C.

Marler, J. G Yadkinville N. C. Marshburn, J. A Elizabethtown N. C. Martin, W. T Benson N. C. Massey, L. M ..Wakefield N. C. Mercer, Wm. C Fountain N. C. Meredith, L. J Wilmington N. C. Miller, C. I Richfield N. C. Moore, L. J St. Paul N. C. Moore, O. L ...Lenoir N. C. Moore, Wm. T Farmville N. C. Morrow, R. M Burlington N. C. Morse, Italy M ..East Bend N. C. Morse, R East Bend N. C. Murphy, R. H Mebane N. C. Murray, Henry V Rock Creek N. C.

Neal, J . M : Salisbury N. C. Netherland, F. B Asheville N. C. Nichols, R. T. Rockingham N. C. Nissen, Eva Carter Winston-Salem N. C.

Nicholson, J. H Harmony N. C. Norris, C. P Durham N. C. Olive, R. M Fayetteville N. C. Olive, T. H Newton N. C.

Osborne, J. C Lawndale N. C. Osborne, J. R Shelby N. C. Owen, J. E Asheville N. C. Parker, J. M Asheville N. C.

Parker, J. V _ New Bern N. C. Parrott, D. W Kinston N. C. Patterson, G. B Fayetteville N. C. Patterson, G. K Wilmington N. C. Pearson, P. L Apex N. C. Peele, C. M Casar, N. C. 76 Proceedings North Carolina Dental Society

Raleigh, Pegram, L. J N. C. Perry, E. A Littleton, N. C. Pitts, H. C High Point, N. C. Pitts, D. R High Point, N. C. Poindexter, C. C East Bend, N. C. Poole, S. D New Hill, N. C Kinston, N. C. Powell, J. W...

Pridgen, D. Leroy - Dunn, N. C. ' Ralph, H. G ..Edenton, N. C. Ralph, W. T Belhaven, N. C. Ramsey, R. L. Salisbury, N. C. Ramsey, W. B Hickory, N. C. Rangeley, C. H Goldsboro, N. C. Ray, W. A - Jacksonville, Fla. Reade, A. P Durham, N. C. Reece, R. W Mt. Airy, N. C. Regan, C. W Laurinburg, N. C. Maxton, N. C. Reid, J. G Reynolds, R. L... Lexington, N. C. Richardson, E. E Leaksville, N. C. Riddick, C. R Ayden, N. C. Robey, W. M.._ Charlotte, N. C. Ross, T. T Nashville, N. C. Russell, A. Y.._ Sanford, N. C. Schultz, A. M Greenville, N. C. Scott, G. G Mebane, N. C. Self, L R., Jr Lincolnton, N. C. Shackelford, E. W Durham, N. C. Shamburger, B. B -Siler City, N. C. Simmerman, D. H 1004 W. Lehigh Ave., Philadelphia, Pa. Asheville, C. Sinclair, J. A N. Smathers, Waxier. Asheville, N. C. Waynesville, N. C. Smathers, J. H Smith, L. T ..Reidsviile, N. C. Smith, W. T Wilmington, N. C.

Smith, E. L..... Raleigh, N. C. Smithson, C. F Rocky Mount, N. C. Smithson, Thos. W Rocky Mount, N. C. Smithwick, D. T Louisburg, N. C. Spence, E. P ....Greenville, N. C. Spoon, R. E Burlington, N. C. C. Spuregon, J. S.... Hillsboro, N. Squires, R. M Wake Forest, N. C.

Stainback, J. F Grant Bldg., Atlanta, Ga. C. Stanly, J. W Wilmington, N. Steelman, S. H YadkinviUe, N. C. Stephens, R. W .Apex, N. C. Swain, John Ashboro, N. C. Proceedings North Carolina Dental Society 77

Tatum, E. W Mt. Olive N. C. Taylor, B. C Landis N. C. Taylor, W. C Salisbury N. C. Teacher, O. A Rose Hill N. C. Thomasson, B. C. Bryson City N. C. Thompson, C. A Wilson N. C. Tomlinson, F. N Winston-Salem N. C. Tomlinson, R. L Smithfield N. C. Trivette, L. P ..Harmony N. C. Tucker, E. J Roxboro N. C. Turlington, R. A Kenly N. C. Turner, Joseph V Hester N. C. Tuttle, R. D Stokesdale N. C. Underwood, F. H ..Fremont N. C.

Underwood, J . T Wilmington N. C. Vanderlinden, W. H Hendersonville N. C.

Waddell, M . A...._ Fair Bluff ,N. C. Waldroup, R. M., Jr Bryson City N. C. Walters, H. N Warrenton N. C. Walters, R. F Virgilina, Va Walton, D. A. Greensboro N. C. Ware, R. E Shelby N. C. Warren, E. R. Goldsboro N. C.

Watkins, J. C Winston-Salem N. C. Watson, S. R Henderson N. C. Waynick, G. E Elon College N. C. Weatherman, W. C Statesville N. C. Weatherbee, R Wilmington N. C. Weaver, R. C Black Mountain N. C. Webster, B. H Charlotte N. C. Weeks, G. E Tarboro N. C.

Wells, J. S Reidsville N. C.

West, J. Frank, Weldon N. C.

Wheeler, J. H. Greensboro N. C. Wheeler, C. M Greensboro N. C.

White, J. H EHzabeth City N. C. White, L Statesville N. C. Whitsett, G. W Greensboro N. C. Wilkins, T. A Gastonia N. C. Williams, Donald Tarboro N. C.

Williamson, J. F Hamlet N. C. Williamson, H. L Duke N. C. Wilson, W. P Durham N. C. Worsham, A. E Ruffin N. C. Wyche, A. E. Greensboro N. C.

Yarbrough, J. A Wake Forest N. C. Yates, W. F Chadbourn N. C.

YeJverton, J. H Wilson N. C. 78 Proceedings North Carolina Dental Society

Yokeley, K. M Route 5, Winston-Salem, N. C.

Young, J. A Newton, N. C. Young, W. D..„ Snow Hill, N. C.

Zimmerman, J. W Salisbury, N. C. The names of those suspended for nonpayment of dues, 1918:

Gower, F. G. Inman, C. I. Haynes, G. C. Lowry, A. A.

Herndon, W. T. Springs, J. S.

MEMBERS IN SERVICE. (Active or Reserve)

Allen. T. I Waynesville N. C. Aycock, B. L Princeton N. C.

Bell, J. G Morehead N. C. Benbow, L. M.._ Winston-Salem N. C. Carr, H. C - Durham N. C. Casstevens, H. E Winston-Salem N. C. Chamberlain, C. H .Yadkinville N. C. Chamberlain, E. H Rockingham N. C. Clayton, W. F High Point N. C. Daniels, L. M Sanford N. C. Dawkins, C. D Hoffman N. C.

'. EUerbee, J . H Clerle N. C. Parrel), R. M Pittsboro N. C. Finch, S. J Oxford N. C Fisher, W. R Concord N. C. Foster, H. K Greensboro N. C. Hall, B. F Asheville N. c! Hamilton, E. S Marshville N. C. Hasty, Vance Statesville N. C. Hollingsworth, W. M Mt. Airy N. C. Holmes, A. G. Jr Southport N. C.

Hurdle, J. H Mebane N. C.

Jernigan . A Dunn N. C. , J Johnson, W. B Smithfield N. C. Jones, P. E Farmville N. C. Keiger, C. C.._ Charlotte N. C.

Lineberger, H . O Raleigh N. C.

McKinney, J. Y Raleigh N. C. McRae, W. L Elroy N. C. Malone, S. E.. Goldsboro N. C.

Mashburn, J. A Elizabethtown N. C. Moore, L. J Carrie N. C. Netherland, F, B Asheville N. C. Pearson, P. L _ Apex N. C. Petterson, G. K „ Wilmington N. C. Rangely, C. H Goldsboro N. C. Proceedings North Carolina Dental Society 79

Reade, A. P Durham, N. C. Russell, A. Y...._ Sanford, N. C. Schultz, A. M Greenville, N. C. Scott, G. G Mebane, N. C. Spoon, R. E Burlington, N. C.

Stainback, J. F..„ Atlanta, Ga. Steelman, S. H.— Harmony, N. C. Teachy, O. A Wallace N. C. Tomlinson, F. N Winston-Salem, N. C. Underwood, F. H.._ Wilson, N. C. Waddell, M. A Fair Bluff, N. C. Waynick, G. E._ Elon College, N. C. Weaver, R. C Asheville, N. C. Worsham, A. E Ruffin, N/C Yates, W. F..__ Chadburn, N. C.. Yokeley, K. M _ Apex, N. C.

Dr. David Edgar Everett 1846-1919